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MATERIA MEDICA 



AND 



THERAPEUTICS 



FOR PHYSICIANS AND STUDENTS. 



V 



BY 



JOHN B. BIDDLE, M. D. 

LATE PROFESSOR OF MATERIA MEDICA AND GENERAL THERAPEUTICS IN THE JEFFERSON MEDICAL 
COLLEGE, PHILADELPHIA. 



THIRTEENTH EDITION 

REVISED, REARRANGED AND ENLARGED, 

WITH SPECIAL REFERENCE TO THERAPEUTICS, TOXICOLOGY, THE PHYSI- 
OLOGICAL ACTION OF MEDICINES, AND CONTAINING ALL THE 
PREPARATIONS AND REMEDIES DESCRIBED IN THE U. S. 
PHARMACOPOEIA OF 1890, TO WHICH THE WORK 
HAS BEEN MADE TO CONFORM^.' 

CLEMENT BIDDLE, M. D. 

MEDICAL CORPS U. S. NAVY. 



WITH NUMEROUS ILLUSTRATIONS. 



PHILADELPHIA : 

P. BLAKISTON, SON & CO., 

No. 1012 Walnut Street. 
1895. 



\ 



n? 




Entered, according to Act of Congress, in the year 1895, by 
P. BLAKISTON, SON & CO., 
In the Office of the Librarian of Congress, at Washington, D. C. 



Press of 

The Jas. B. Rodgers Printing Co. 

52 <ft 54 N. Sixth Street, 

Philadelphia. 



EDITORS PREFACE 



TO THE THIRTEENTH EDITION. 



In offering this edition of the Materia Medica and Thera- 
peutics to students and practitioners, the editor desires here to call 
attention to the various changes, alterations, additions and omissions 
made by him which he trusts will keep the work abreast with medical 
progress and make it a reliable text-book upon the subjects of which 
it treats. 

This work was first issued in 1865. Shortly after the death of 
the author in 1879 a reprint of the Eighth Edition was published 
unchanged as the Eighth Edition. The Ninth, Tenth and Eleventh 
were written conjointly by the editor and Dr. Henry Morris ; the 
Twelfth and Thirteenth by the editor alone. 

In preparing this issue the same order, in the consideration of 
each drug or remedy, has been observed, wherever practicable, as in 
the preceding edition, namely; (1) Description, Source, Habitat, 
Varieties ; (2) Preparation ; (3) Chemical Constituents, Proper- 
ties, Tests; (4) Incompatibles ; (5) Aids; (6) Contraindications; 
(7) Physiological Effects, or Effects and Uses ; (8) Toxicology 
and Antidotes; (9) Medicinal Uses, (a) Internally, (b) Topically ; 
(10) Administration, including in certain instances Preservation. 
As regards Physiological Effects the following plan has been fol- 
lowed, viz. : Firstly, local action, comprising analgesic, irritant, anti- 
septic, pupillary effects, etc. ; secondly, internal action, beginning with 
taste, and then the effect upon the stomach, secretions, nervous, 
vascular, respiratory and muscular systems, temperature and elimina- 
tion. 

As this edition is intended to include all the articles and prepa- 
rations considered in the United States Pharmacopoeia of 1890, it has 
been necessary to add the following items to complete the list. Of 
this list some heretofore contained have been made official. Wherever 
the Latin title of any preparation is given along with the English 

5 



6 PREFACE TO THE THIRTEENTH EDITION. 

equivalent, both in italics, it is to be understood that such preparation 
is official, unless otherwise stated. The list of chief official additions is : 



Acidum hypophosphorosum dilutum. 

Acid urn stearicum. 

Alcohol absolutum and deodoratum. 

A loin uni. 

Aqua auranlii florum. 

chloroformi. 

hydrogenii dioxidi. 

rosae fortior. 
Aspidosperma. 
Barii dioxidum. 
Caffeina citrata. 

citrata effervescens. 
Calcii sulphas exsiccatus. 
Cocainae hydrochloras. 
Convallaria. 
Elastica. 
Elixir aromaticuni. 

phosphori. 
Eriodictyon. 
Eucalyptol. 
Extractum apocyni fluidum. 

asclepias fluidum. 

aspidospermatis fluidum. 

cimicifugae. 

convallariae fluidum. 

eriodictyi fluidum. 

jalapae. 

lappae fluidum. 

menispermi fluidum. 

phytolaccae radicis fluidum. 

rhamni purshianae fluidum. 

scoparii fluidum. 

uvae ursi fluidum. 

viburnum opuli fluidum. 
Ferri et quininae citras solubilis. 
Glyceritum acidi carbolici. 

acidi tannici. 

boroglycerini. 

hydrastis. 



Hydrastinae hydrochloras. 

Hyoscinae hydrobromas. 

Hyoscyaminae hydrobromas. 

Lappa. 

Lithii citras effervescens. 

Menthol. 

Methyl salicylas. 

Oleatum zinci. 

Oleum betulae volatile. 

cadinum. 

terebinthinae rectificatum. 
Petrolatum liquidum. 

spissum. 
Physostigminae sulphas. 
Pilulae catharticae vegetabiles. 

ferri carbonatis. 
Potassii citras effervescens. 
Pyrogallol. 
Rhamnus purshiana. 
Sapo; sapo mollis. 
Sodii nitris. 
Sparteinae sulphas. 
Spiritus amygdalae amarae. 
Spintus aurantii compositus. 

glonoini. 

phosphori. 
Strontii bromidum. 

iodidum. 

lactas. 
Strophanthus. 
Suppositoria glycerini. 
Terebenum. 
Terpini hydras. 
Tinctura lactucarii. 

quillajse. 

strophanthi. 
Trochisci santonini. 
Viburnum opulus. 
Zea. 



The list of unofficial additions is : 



Alumnol. 

Antitoxine. 

Barley water. 

Bran. 

Charpie. 

Chloralamide. 

Creolin. 

Cresols. 

Diuretin. 

Eugenol. 

Gallanol. 

Guaiacol. 

Hard soap. 

Hydrogen peroxide. 

Lint. 



Liquor carbonis detergens. 

Lysol. 

Oakum. 

Oleates of copper, bismuth and cocaine. 

Phenacetine. 

Phenocoll hydrochloride. 

Piperazine. 

Remedies, list of under trial, in Appendix. 

Rhigolene. 

Salipyrin. 

Salophen. 

Sponge. 

Talc. 

Thiol. 

Tricresols. 



PREFACE TO THE THIRTEENTH EDITION. 



List of all articles dropped 

All the abstracta. 

Acetum lobeliae and sanguinariae. 

Ammonii phosphas and sulphas. 

Amylum iodatum. 

Aurantii flores. 

Azedarach. 

Cannabis Americana. 

Ceratum extracti cantharidis. 

Ceratum sabine. 

Charta cantharidis. 

Chian turpentine. 

Chinoidinum. 

Chinoline. 

Croton-chloral-hydrate. 

Chloroformum venale. 

Cornus. 

Cupri acetas. 

Cydonium. 

Elixir aurantii. 

Emplastrum ammoniaci. 

asafoetidse. 

galbani. 

picis canadensis. 
Extractum cornus fluidura. 

lactucarii fluidum. 

mezerei. 
Ferri oxalas. 
Galbanum. 

Hydrargyri sulphidum rubrum. 
Hypnone. 
Ignatia. 

Infusum brayerae. 
Kairine. 
Linimentum cantharidis. 

plumbi subacetatis. 
Liquor ferri et quininae citratis. 

pepsini. 



Magnesii sulphis. 

Magnolia. 

Mistura magnesias et asafoetidae. 

potassii citratis. 
Mucilago cydonii. 
Oleum lavandulae. 

succini. 
Origanum. 
Pilula? ferri compositas. 

galbani composite. 
Pix canadensis. 
Polygonum hydropiperoides. 
Potassii sulphas and tartras. 
Pyridine. 
Rosmarinus. 
Salix. 
Sodii bicarbonas venalis. 

santoninas. 
Syrupus ferri bromidi. 

limonis. 
Thalline. 
Tinctura conii. 

ferri acetatis. 

ignatiae. 
Trochisci magnesiae. 

sodii santoninatis. 
Unguentum mezerei. 

sulphuris alkalinum. 
Urethan. 
Ustilago. 
Vinum album fortius. 

aloes. 

aromaticum. 

rhei. 
Viola tricolor. 



In the list of Natural Mineral Waters two containing lithium salts 
have been given a place, viz. : Londonderry and Buffalo. Under 
Mechanical Remedies the stomach-pump and gastric lavage are 
briefly considered. The chapter on Electricity has been carefully 
revised, the terms in use concisely defined and some new matter 
inserted concerning electrical action. The paragraph on Incompati- 
bility has been amplified to the extent of making it, it is believed, 
complete enough to be of service as a guide to students in the com- 
position of prescriptions ; and a chapter on Prescription Writing 
inserted. The article on Hydrastis is entirely new. 

With the view of adding practical value to the work, various 
changes find place, particularly in the methods of applying remedies 
to the eye and throat, the dispensing of disagreeable medicines in 



8 PREFACE TO THE THIRTEENTH EDITION. 

capsules or tablet triturates, the sorts of enemata in use, and the 
making- of poultices. 

A new order, viz. : Protectants and Absorbents, is introduced 
under Topical Medicines, with which has been grouped certain 
articles, as charcoal, adhesive plaster, etc., that seem to be more 
appropriately there considered than at other places. The Ferrugi- 
nous Preparations are transferred from Tonics to Haematinics. 

Attention is called to the enlarged Appendix, where will be found 
A Dietary List for the Sick ; A Table of Doses for Adults, arranged 
in the Apothecaries' and Metric Systems, with in many instances the 
maximum quantity in 24 hours; Solutions for Hypodermic Use ; A 
List of New Remedies under Trial, and A Table of Parasites. 

The work proper is increased by fifteen and the Appendix by six- 
ty pages — in all an addition of seventy-five pages. The Index to 
Contents is amplified, the page-numbers being qualified by brief state- 
ments in order to make the contents of easy reference, and the Index 
of Diseases and Remedies has received a most careful revision. 

The editor here desires to thank most cordially Dr. T. D. Reed, 
of the Montreal College of Pharmacy, for various valuable correc- 
tions and suggestions kindly furnished and offered by him for this 
edition as well as for previous issues. His thanks are also due to 
Prof. F. B. Power, who contributed much matter of value, particularly 
that relating to the structure of the alkaloids, the essential oils, and 
the composition of certain plants. To Dr. Henry Morris, of Phila- 
delphia, the editor's acknowledgments are likewise due for much 
matter contributed to former editions, notably the chapter on Anti- 
septics and Antipyretics. 

To any one discovering errors in this work, and who will take the 
trouble to report the same to the editor for the sake of future accu- 
racy, sincere thanks will be returned. 

The editor takes great pleasure, as in former editions, in renewing 
his dedication of this work to the gentlemen in attendance at the 
various medical schools of North America. 



Clement Biddle, M.D., 

United States Navy 



181 1 Walnut Street, 
Philadelphia, January, 1895. 



AUTHOR'S PREFACE 



TO THE EIGHTH EDITION. 



The exhaustion of the seventh edition of the Materia Medica 
within little more than a year since it was issued, having rendered 
necessary the publication of a new edition, it has been carefully 
revised, much of it has been recast and even rewritten, and many 
new articles have been added. The author trusts that it will be 
found to have kept pace with the progress of pharmacological 
science, and to contain all important recent contributions to the 
various departments of pharmacology. 

The illustrations of the book comprise, as in previous editions, 
representations of most of the important indigenous and natural- 
ized plants, as well as diagrams of instruments employed in the 
atomization of liquids in the new operation of pneumatic aspiration, 
in the transfusion of blood, and in the recently-introduced pneu- 
matic method in the treatment of thoracic diseases. 

The author has aimed in this, as in previous editions, to present 
a succinct account of the articles of the Materia Medica in general 
use in the United States, and discussed in the course of lectures 
delivered upon the subject, to which he trusts the work will be 
found, as heretofore, to furnish a suitable text-book. He takes 
pleasure in renewing his dedication of it to the gentlemen in 
attendance upon the various medical schools of North America. 

John B. Biddle. 



CLASSIFIED TABLE OF CONTENTS. 



PAGE 

Remedies — Definition of 25 

Division of . , 25 

Materia Medica — Definition of 25 

Therapeutics — Definition of 25 

Division of . 25 

Rational 25 

Empirical 25 

PART I. 

MECHANICAL REMEDIES. 

General Blood-letting 26 

Local Abstraction of Blood - 27 

Leeches and Cups 27 

Scarifications 28 

Setons and Issues 28 

Bandages, Frictions . _ . 28 

Acupuncture, Pneumatic Aspiration 29 

Gastric Lavage, Stomach-Pump 31 

PART II. 

IMPONDERABLE REMEDIES. 

Light 3 2 

Heat (hot baths, bottles, fomentations, actual cautery, etc.) 32-3-4 

Cold (cold baths, cold wet-sheet, ice-bag, cracked ice, etc.) 35—6-7 

Electricity (Static, Galvanic, Faradic) 37 

Definition of terms in use 4° 

Electrical Diagnosis 4 1 

Electrolysis, Galvano-cautery 46 

Massage 46 

Swedish Movement Cure 4-8 

Weir Mitchell Treatment 4-8 



PART III. 

PHARMACOLOGICAL REMEDIES. 
t 

Pharmacological Remedies, or Medicines, definition of 49 

Pharmacology, meaning of 49 

Pharmacy, definition of 49 

11 



12 COy TENTS. 

PAGE 

Materia Medica. limitation of 49 

U. S. Pharmacopoeia defined 49 

Dispensatory 5° 

Materia Medica. inorganic, animal, and organic classified and defined 50 

Medicines — Modus operandi of 52 

General circumstances which modify the effects of 54 

Incompatibility of 54 

Forms in which exhibited 56 

Solids 56 

Liquids 58 

Semi-solids 62 

Gases and Vapors 63 

Weights and Measures 63 

Prescription Writing 67 

Effects of Age, Sex, Habit, Idiosyncrasy, etc., upon 71 

Parts to which applied 73 

To the Skin (Epidermic Method, Inunction, etc.) 73 

The Hypodermic Method 74 

To Mucous Membranes 75 

Conjunctival (Eye-wash, Disk, etc.) 75 

Nasal (Douche, Powder, etc.) 75 

Buccal and Pharyngeal (Gargle, Lozenge, Spray) 76 

Eustachian Tubes 76 

External Auditory Canal (Instillation, Insufflation, etc.) 76 

Tracheo-Bronchial (Atomization, Inhalation) 76 

r r ™ i 

I Stomach 1 

( Powder, etc. 

Gastro-Intestinal -J \- 79 

{Suppository 
I 
Enema 

Vagino-Uterine, Urino-Genital (Syringe, Suppository) ...... 79 

To Serous Membranes 80 

To Ulcers, Wounds, Abscesses 80 

Classifications of Medicines 80 

Class I. — Neurotics 81 

Order I. Narcotics , 81 

Opium 82 

Lactucarium 93 

Paraldehydum 94 

Sulphonal 96 

Chloralamide 97 

Belladonna 98 

Stramonium 105 

Hyoscyamus 106 

Duboisia 109 

Cannabis Indica (Female Plant) in 

Humulus ( Hops) 113 

Dulcamara (Bittersweet) 114 



CONTENTS. 13 

PACK 

Order II. Ethei-eal Anaesthetics 115 

^Ether 115 

^Ether Aceticus 119 

Chloroformum 120 

Methylene Bichloride . . . . 123 

Nitrous Oxide Gas . , 124 

Ethyl Bromide 125 

Local Anaesthesia 125 

Carbon Disulphidum 125 

Order III. Antispasmodics 126 

Asafcetida (Asafetida) 126 

Ammoniacum (Ammoniac) 128 

Camphora (Camphor) 128 

Camphora Monobromata (Monobromated Camphor) 131 

Valeriana (Valerian) 131 

Ammonii Valerianas (Ammonium Valerianate) 132 

Cypripedium (Ladies' Slipper) 132 

Scutellaria (Skullcap) 133 

Thea (Tea) 133 

Caffea (Coffee) 133 

Caffeina (Caffeine) 134 

Theobroma (Chocolate) 134 

Coca 135 

Cocaine '. . 135 

Guarana 141 

Mate (Paraguay Tea) 141 

Moschus (Musk) 141 

Oleum ^Ethereum (Ethereal Oil) 142 

Spiritus yEtheris Nitrosi (Compound Spirit of Ether) 142 

Order IV. Tonics 143 

Vegetable Tonics 144 

Pure Bitters 144 

Quassia 144 

Gentiana (Gentian) 145 

Calumba (Columbo) 146 

Berberine 147 

Chirata 148 

Aromatic Bitters 148 

Serpentaria (Virginia Snakeroot) 148 

Eucalyptus 149 

Anthemis (Chamomile) I5 1 

Eupatorium (Thorough wort) 15 l 

Absinthium (Wormwood) 15 2 

Cascarilla l 53 

Eriodictyon 1 53 

Astringent Bitters 154 

Cinchona • ■ • • • i"54 

Quininae Sulphas (Quinine Sulphate) 162 

Quininae Bisulphas (Quinine Bisulphate) • • 163 



14 CONTENTS. 



PAGE 



Quininse Valerianas (Quinine Valerianate) 163 

Quininse Hydrobromas (Quinine Hydrobromate) 163 

Quininse Hydrochloras (Quinine Hydrochlorate) 163 

Cinchoninse Sulphas (Cinchonine Sulphate) 163 

Quinidinse Sulphas (Quinidine Sulphate) 164 

Cinchonidinse Sulphas (Cinchonidine Sulphate) 164 

Salix (White Willow) ' 164 

Salicinum (Salicin) 164 

Prunus Virginiana (Wild Cherry) 165 

Digestive Ferments 165 

Pepsinum (Pepsin) ■ 165 

Ingluvin 166 

Fel Bovis (Oxgall) 167 

Pancreatinum (Pancreatin) 167 

Papaya 167 

Mineral Tonics 168 

Mangani Prseparata (Preparations of Manganese) 168 

Acida Mineralia (Mineral Acids) 169 

Acidum Lacticum (Lactic Acid) 175 

Strontii Lactas (Strontium Lactate) 176 

Phosphorus 176 

Zinc Phosphide 179 

Order V. Astringents ... 179 

Vegetable Astringents 180 

Acidum Tannicum (Tannic Acid) 180 

Acidum Gallicum (Gallic Acid) 182 

Galla (Nutgall) 183 

Catechu 184 

Kino 185 

Krameria (Rhatany) 185 

Hsematoxylon (Logwood) 186 

Quercus Alba (White Oak) 186 

Geranium (Crowfoot, or Cranesbill) 188 

Hamamelis (Witchhazel) 188 

Rumex (Yellow Dock) 189 

Rosa Gallica (Red Rose) 189 

Rosa Centifolia (Pale Rose) 189 

Oleum Rosse (Oil of Rose) 190 

Rhus Glabra (Sumach) 190 

Rubus (Blackberry) 190 

Rubus Idseus (Raspberry) 190 

Castanea (Chestnut) . . . . • ; 190 

Mineral Astringents 191 

Plumbi Prseparata (Preparations of Lead) 191 

Cupri Prseparata (Preparations of Copper) 196 

Zinci Praeparata (Preparations of Zinc) 198 

Argenti Prseparata (Preparations of Silver) 201 

Bismuthi Prseparata (Preparations of Bismuth) 205 

Cerii Oxalas (Cerium Oxalate) ' 207 



CONTENTS. 15 



PAGB 



Alumen (Alum) 207 

Alumini Sulphas (Aluminium Sulphate) 209 

Alumini Hydras (Aluminium Hydrate) 209 

Alum-Waters 209 

Order VI. Stimulants 209 

Alcohol 210 

Alcohol Absolutum (Absolute Alcohol) 215 

Alcohol Deodoratum (Deodorized Alcohol) 215 

Alcohol Dilutum (Diluted Alcohol) 215 

Vinum (Wine) 215 

Vinum Album (White Wine) 215 

Vinum Rubrum (Red Wine) 215 

Spiritus Vini Gallici (Brandy) 216 

Spiritus Frumenti (Whiskey) 216 

Spiritus Sacchan (Rum) 216 

Gin 216 

Spiritus Myrciae (Bay Rum) 216 

Malt Liquors (Porter and Ale) 216 

Extractum Malti (Malt Extract) . . 216 

Ammoniae Praeparata (Preparations of Ammonia) 217 

Aromatics .221 

Capsicum (Cayenne Pepper) 222 

Piper (Black Pepper) 223 

Piperinum 223 

Cinnamomum (Cinnamon) 224 

Myristica (Nutmeg) 224 

Macis (Mace) 224 

Caryophyllus (Cloves) 225 

Pimenta (Allspice) 226 

Oleum Cajuputi (Oil of Cajuput) 226 

Zingiber (Ginger) 226 

Cardamomum (Cardamom) 227 

Pulvis Aromaticus (Aromatic Powder) 228 

Extractum Aromaticum Fluidum (Aromatic Fluid Extract) 228 

Calamus (Sweet Flag) 228 

Gaultheria (Partridge Berry) 229 

Oleum Gaultherise (Oil of Gaultheria) 229 

Methyl Salicylas (Methyl Salicylate) 230 

Oleum Betulse Volatile (Volatile Oil of Betula) 230 

Aurantii Amari Cortex (Bitter Orange-Peel) 230 

Aurantii Dulcis Cortex (Sweet Orange-Peel) - 230 

Aromatics belonging to the Nat. Ord. Labiatve 231 

Lavandula (Lavender) 231 

Mentha Piperita (Peppermint) 231 

Mentha Viridis (Spearmint) 231 

Menthol (Mint Camphor) 232 

Hedeoma (Pennyroyal) 233 

Marrubium (Horehound) 233 

Salvia (Sage) 2 33 



16 COXTEXTS. 

PAGE 

Oleum Thymi (Oil of Thyme) 233 

Aromatic seeds derived from the A T at. Ord, Umbellifer^e, except 

Illicium 233 

Fceniculum (Fennel) 234 

Carum (Caraway) 234 

Anisum (Anise) 234 

Coriandrum (Coriander) 234 

Illicium (Star-Anise) 234 

Vanilla 234 

Oleum Bergamottse (Oil of Bergamot) 234 

Order VII. Sedatives 235 

Aconitum (Aconite) 235 

Veratrum Viride (American Hellebore) 241 

Veratrina (Veratrine) 244 

Pulsatilla (Pasque Flower) 246 

Arnica (Leopard's Bane) 246 

Phytolacca (Poke Root) 247 

Staphisagria (Stavesacre or Lice Bane) 248 

Antimonii Praeparata (Preparations of Antimony) 249 

Potassii Nitras (Potassium Nitrate) 253 

Sodii Nitras (Sodium Nitrate) 255 

Refrigerants 255 

Potassii Citras (Potassium Citrate) 255 

Liquor Ammonii Acetatis (Solution of Ammonium Acetate "1 256 

Spiritus ^Etheris Nitrosi (Spirit of Nitrous Ether) 256 

Acida Vegetabilia (Vegetable Acids) 257 

Order VIII. Spinants 259 

Excito-Motors 260 

Nux Vomica 260 

Strychnina (Strychnine) 260 

Strychninse Sulphas (Strychnine Sulphate) 265 

Hydrastis (Golden Seal) . . . , 265 

Hydrastininse Hydrochloras (Hydrastinine Hydrochlorate) 267 

Rhus Toxicodendron (Poison Ivy) 268 

Cocculus Indicus 268 

P*icrotoxinum (Picrotoxin) 268 

Ergota (Ergot) 269 

Gossypii Radicis Cortex (Bark of Cotton Root) 275 

Digitalis (Fox Glove) 276 

Adonidin 281 

Strophanthus 282 

Sparteine 283 

Sparteine Sulphas (Sparteine Sulphate) 284 

Convallaria (Lily of the Valley) 285 

Cimicifuga (Black Snake Root) 285 

Depresso-Motors 287 

Coniurn (Hemlock) , . . 287 

Physostigma (Calabar Bean) 290 

Chloral 292 

Potassii Bromidum (Potassium Bromide) 296 



CONTENTS. 



Ammonii Bromidum (Ammonium Bromide) ' 300 

Sodii Bromidum (Sodium Bromide) 301 

Lithii Bromidum (Lithium Bromide) 301 

Calcii Bromidum (Calcium Bromide) 301 

Zinci Bromidum (Zinc Bromide) 301 

Strontii Bromidum (Strontium Bromide) 301 

Acidum Hydrobromicum Dilutum (Diluted Hydrobromic Acid) .... 301 

Tabacum (Tobacco) 302 

Lobelia 304 

Acidum Hydrocyanicum Dilutum (Diluted Hydrocyanic Acid) .... 307 

Potassii Cyanidum (Potassium Cyanide) 310 

Oleum Amygdala Amarae (Oil of Bitter Almond) 310 

Syrupus Amygdalae (Syrup of Almond) 311 

Spiritus Amygdalae Amarae (Spirit of Bitter Almond) 311 

Amyl Nitris (Amyl Nitrite) 311 

Nitroglycerinum (Nitroglycerin) 313 

Potassium Nitrite ~> 

Sodium Nitrite I • 3 5 

Gelsemium (Jasmine) 315 

Woorara 317 

Viburnum Prunifolium (Black Haw) 318 

Viburnum Opulus (Cramp Bark) ... .. 319 

Grindelia • 320 

Sumbul 321 

Aspidosperma 322 

Class II. — Eccritics 322 

Order I. Emetics 322 

Vegetable Emetics 324 

Ipecacuanha (Ipecac) 324 

•Sanguinaria (Blood Root) 327 

Apomorphinae Hydrochloras (Apomorphine Hydrochlorate) 329 

Sinapis (Mustard) 330 

Tobacco and Lobelia 330 

Mineral Emetics 331 

Order II. Cathartics 331 

Laxatives . . . 332 

Tamarindus (Tamarind; 332 

Ficus (Fig) 333 

Manna 333 

Cassia Fistula (Purging Cassia) • . 333 

Oleum Olivae (Olive Oil) 334 

Oleum Amygdalae Expressum (Expressed Oil of Almond) 334 

Oleum Ricini (Castor Oil) 334 

Oleum Lini (Linseed Oil) 337 

Sulphur 337 

Potassa Sulphurata (Sulphurated Potassa) . 339 

Sulphur Waters (North American) 34° 

Sulphur Waters (European) 34° 

Saline Cathartics 34 1 



18 CONTENTS. 

PAGE 

Magnesia 343 

Magnesia Ponderosa (Heavy Magnesia) 343 

Magnesii Carbonas (Magnesium Carbonate) 343 

Magnesii Sulphas (Magnesium Sulphate, Epsom Salt) 344 

Liquor Magnesii Citratis (Solution of Magnesium Citrate) 345 

Magnesii Citras Effervescens (Effervescent Magnesium Citrate) .... 345 

Sodii Sulphas (Sodium Sulphate, Glauber's Salt) 345 

Mangani Sulphas (Manganese Sulphate) 346 

Sodii Phosphas (Sodium Phosphate) 346 

Sodii Pyrophosphas (Sodium Pyrophosphate) 347 

Potassii Sulphas (Potassium Sulphate) 347 

Potassii Bitartras (Potassium Bitartrate) 347 

Potassii et Sodii Tartras (Potassium and Sodium Tartrate, Rochelle Salt) 348 

Saline Mineral Waters (North American) 349 

Saline Mineral Waters (European) 351 

Mild Acrid Cathartics 353 

Rheum (Rhubarb) 353 

Juglans (Butternut) 355 

Aloe (Aloes) 356 

Senna 357 

Leptandra (Culver's Root) 359 

Frangula (Buckthorn) 359 

Rhamnus Purshiana (Cascara Sagrada) 360 

Hydragogue Cathartics 361 

Jalapa (Jalap) 361 

Bryonia (Bryony) 363 

Podophyllum (May Apple or Mandrake) 363 

Chelidonium (Celandine) 365 

Iris (Blue Flag) 366 

Euonymus (Wahoo) 367 

Scammonium (Scammony) 368 

Colocynthis (Colocynth) 369 

Cambogia (Gamboge) 370 

Elaterinum (Elaterin) 371 

Oleum Tiglii (Croton Oil) 372 

Mercurial Cathartics • 374 

Enemata 375 

Order III. Diaphoretics 377 

Pilocarpus (Jaborandi) 378 

Alterative Diaphoretics 380 

Sarsaparilla 381 

Guaiaci Lignum (Guaiac Wood) 382 

Guaiaci Resina (Guaiac) 382 

Mezereum , 383 

Xanthoxylum (Prickly Ash) 384 

Menispermum (Yellow Parilla, Canadian Moonseed) 385 

Calendula (Marigold) 385 

Sassafras 385 

Stillingia (Queen's Root) 386 



CONTENTS. 19 



PAGE 



Lappa (Burdock) 386 

Asclepias (Pleurisy Root) 386 

Melissa (Balm) 386 

Order IV. Diuretics 387 

Potassii Acetas (Potassium Acetate) 388 

Sodii Acetas (Sodium Acetate) ..-..,..:.» 388 

• Scilla (Squill) 389 

Colchicuni ' 391 

Oleum Erigerontis (Oil of Erigeron) 305 

Apocynum (Canadian Hemp) 395 

Taraxacum (Dandelion) . . 396 

Triticum (Couch-grass) . . 397 

Juniperus (Juniper) 398 

Scoparius (Broom) 399 

Zea (Corn-silk) 399 

Cantharis (Cantharides) 399 

Sambucus (Elder) 400 

Order V. Blennorrheas ... 400 

Senega 400 

Quillaja (Soap-bark) 40.2 

Allium (Garlic) 403 

Scilla (Squill) 404 

Terebinthina (Turpentine) 404 

Oleum Terebinthinse (Oil of Turpentine) 406 

Terebenum (Terebene) 408 

Terpini Hydras (Terpin Hydrate) 408 

Pix Liquida (Tar) 408 

Copaiba (Balsam of Copaiba) 410 

Cubeba (Cubebs) 412 

Oleum Santali (Oil of Sandal- wood) 414 

Matico . . . . , 415 

Pareira 415 

Buchu 416 

Uva Ursi (Bearberry) 4 ID 

Chimaphila (Pipsissewa) . 417 

Myrrha (Myrrh) 419 

Benzoinum (Benzoin) 4 T 9 

Styrax (Storax) ... 421 

Balsamum Peruvianum (Balsam of Peru) 421 

Balsamum Tolutanum (Balsam of Tolu) 4 22 

Mastiche (Mastic) 4 22 

Anacyclus Pyrethrum 4 22 

Order VI. Emmenagogues • 423 

Sabina (Savine) 4 2 3 

Oleum Rutae (Oil of Rue) 4 2 4 

Tanacetum (Tansy) 4 2 5 

Caulophyllum (Blue Cohosh) 4 26 

Inula (Elecampane) 4 2D 

Apiol (Parsley Camphor) 4 2 ^ 



JO CONTENTS. 

rAGE 

Class ill. -H.kmatics 427 

Order 1. lLvmatinics 427 

Kerri Pneparata (Preparations of Iron) 427 

Chalybeate Waters (North American) 437 

Chalybeate Waters (European) " 438 

Order II. Alteratives '. 438 

Hydrargyri Prseparata (Preparations of Mercury) V . , 439 

Auri et Sodii Chloridum (Gold and Sodium Chloride) 458 

Iodum (Iodine) 458 

Potassii Iodidum (Potassium Iodide) 462 

Ammonii Iodidum (Ammonium Iodide) 465 

Sodii Iodidum (Sodium Iodide) 465 

Strontii Iodidum (Strontium Iodide) 465 

Sulphuris Iodidum (Sulphur Iodide) 465 

Syrupus Acidi Hydriodici (Syrup of Hydriodic Acid) 466 

Oleum Morrhuae (Cod-liver Oil) ' . . 466 

Arsenii Praeparata (Preparations of Arsenic) 469 

Calcii Phosphas Praecipitatus (Precipitated Calcium Phosphate) .... 478 

Syrupus Calcii Lactophosphatis (Syrup of Calcium Lactophosphate) . . 478 

Calcii Hypophosphis (Calcium Hypophosphite) 478 

The Hypophosphites and Their Preparations 478 

Potassii Hypophosphis (Potassium Hypophosphite) 479 

Sodii Hypophosphis (Sodium Hypophosphite) 479 

Syrupus Hypophosphitum (Syrup of Hypophosphites) . . .... 479 

Syrupus Hypophosphitum cum Ferro (Syrup of Hypophosphites with 

Iron) 479 

Calcii Chloridum (Calcium Chloride) 479 

Potassii Chloras (Potassium Chlorate) 480 

Sodii Chloras (Sodium Chlorate) 481 

Potassii Bichromas (Potassium Bichromate) 482 

Order III. Antacids 483 

Potassii Praeparata (Potassium Preparations) 484 

Sodii Praeparata (Sodium Preparations) 487 

Alkaline Mineral Waters (North American) 489 

Alkaline Mineral Waters (European) 490 

Lithii Praeparata (Lithium Preparations) 492 

Lithian Mineral Waters 493 

Ammonii Praeparata (Ammonium Preparations) 493 

Magnesii Praeparata (Magnesium Preparations) 493 

Calcii Praeparata (Calcium Preparations) 494 

Calcareous Waters (North American) 496 

Calcareous Waters (European) 496 

Class IV. — Topical Medicines 496 

Order I. Antiseptics and Antipyretics 496 

Potassii Permanganas (Potassium Permanganate) 49^ 

Aqua Chlori (Chlorine Water) 499 

Calx Chlorata (Chlorinated Lime) 500 

Liquor Sodae Chloratae (Solution of Chlorinated Soda) 500 

Hydrargyri Chloridum Corrosivum (Corrosive Mercuric Chloride) . . . 501 



CONTENTS. 21 

PAGE 

Hydrogenii Peroxidum (Hydrogen Peroxide) 502 

Bromum (Bromine) 50^5 

Iodum (Iodine) 503 

Hydrargyri Iodidum Rubrum (Red Mercuric Iodide) 503 

Acidum Sulphurosum (Sulphurous Acid) . ... 503 

Sodii Sulphis (Sodium Sulphite) 504 

Sodii Bisulphis (Sodium Bisulphite) c 504 

Sodii Hyposulphis (Sodium Hyposulphite) 504 

Sulphides 505 

Calx Sulphurata (Sulphurated Lime) 505 

Acidum Boricum (Boric Acid, Boracic Acid) 505 

Glyceritum Boroglycerini (Glycerite of Boroglycerin) 507 

Sodii Boras (Sodium Borate) 507 

Derivatives of the Organic Radical Phenyl 508 

Chemistry of Phenyl 508 

Acidum Carbolicum (Carbolic Acid, Phenol) 510 

Sodii Sulpho-carbolas (Sodium Sulpho-carbolate) 515 

Creosotum (Creosote) 516 

Guaiacol 518 

Cresols (Creolin) 518 

Tricresol 518 

Lysol 519 

Nitro-Benzine 519 

Benzinum (Benzin) 519 

Aniline 519 

Acetanilidum (Acetanilid) 5 2 ° 

Exalgine J^Methylacetanilide) 5 22 

Acidum Benzoicum (Benzoic Acid) 524 

Sodii Benzoas (Sodium Benzoate) 524 

Ammonii Benzoas (Ammonium Benzoate) 5 2 5 

Resorcinum (Resorcin) 525 

Hydroquinone and Pyrocatechin 5 2 7 

Acidum Salicylicum (Acid Salicylic) 527 

Sodii Salicylas (Sodium Salicylate) 530 

Lithii Salicylas (Lithium Salicylate) 530 

Salol . 531 

Naphthalinum (Naphthalin) 533 

Salophen 534 

Naphtol (Naphtol) 534 

Antipyrine 53^ 

Antipyrine Salicylate (Salipyrin) . . 53$ 

Phenacetine 53& 

Antiseptic Oils, the Camphors, Menthol 53& 

Phenocoll Hydrochloride .... 539 

Remedies used Chiefly for Topical Antisepsis, beginning with Iodoform . 539 

Iodoformum (Iodoform) 539 

Aristol 54 2 

Iodol 544 

Thymol • • 545 



22 CONTENTS. 

PAGE 

Lysol 546 

Eugenol 546 

Icthyol 547 

Thiol , 54 8 

Dermatol l 549 

Gallanol 549 

Alumnol 549 

Order III. Irritants 549 

Rubefacients 55° 

Sinapis Alba (White Mustard) 55° 

Sinapis Nigra (Black Mustard) 55° 

Capsicum ^53 

Oleum Terebinthinse (Oil of Turpentine) 553 

Linimentum Ammoniae (Liniment of Ammonia) 554 

Pix Burgundica (Burgundy Pitch) 554 

Other Rubefacients, as Camphor, Menthol, Chloroform, etc 555 

Epispastics 555 

Cantharis (Cantharides) 55^ 

Cantharis Vittata (Potato-Flies) .... 560 

Aqua Ammoniae Fortior (Stronger Water of Ammonia) 561 

Suppurants 561 

Oleum Tiglii [Croton Oil) 561 

Unguentum Antimonii (Antimonial Ointment) 561 

Escharotics 561 

Argenti Nitras Fusus (Fused Silver Nitrate) 562 

Potassa 562 

Potassa cum Cake ^ 563 

Soda 563 

Acidum Chromicum 563 

Acidum Arsenosum 564 

Bromum (Bromine) 564 

Zinci Chloridum (Zinc Chloride) 565 

Liquor Hydrargyri Nitratis (Solution of Mercuric Nitrate) 565 

Hydrargyri Chloridum Corrosivum (Corrosive Chloride of Mercury) . . 565 

' Potassii Bichromas (Potassium Bichromate) 565 

Acida Mineralia (Mineral Acids) 566 

Copper Sulphate, Alum and Heat , . . . . 566 

Sapo Durus (Hard Soap) 566 

Sapo Mollis (Soft Soap) ' 566 

Sapo Viridis (Green Soap) 566 

Chrysarobinum (Chrysarobin) 567 

Pyrogallol 56S 

Order III. Demulcents 569 

Cataplasms or Poultices 570 

Aqua (Water), 571; (Carbonic Acid Water), (Apollinaris, Clysmic 

Water, etc.) - 572 

Acacia (Gum Arabic) 5^2 

Tragacantha CTragacanth) 574 

Linum (Linseed) z-ja 

Oleum Gossypii Seminis (Cotton Seed Oil) 576 



CONTENTS. 23 



PAGE 



Ulmus (Slippery Elm) 576 

Sassafras Medulla (Sassafras Pith) -577 

Althaea (Marshmallow) 577 

Oleum Sesami (Oil of Benne) 578 

Glycyrrhiza (Liquorice Root) 578 

Glycyrrhizinurn Ammoniatum (Ammoniated Glycyrrhizin) 579 

Extractum Glycyrrhizae (Extract of Liquorice) 579 

Cetraria (Iceland Moss) 580 

Chondrus (Irish Moss) 581 

Amylum (Starch) 582 

Glyceritum Amyli 583 

Animal Fats 583 

Adeps (Lard) 584 

Adeps Benzoinatus (Benzoinated Lard) 584 

Adeps Lanae Hydrosus (Hydrous Wool Fat) (Lanolin) 584 

Sevum (Mutton Suet) 585 

Cetaceum (Spermaceti) 585 

Cera Flava (Yellow Wax) 585 

Cera Alba (White Wax) 585 

Acidum Oleicum (Oleic Acid) 585 

Acidum Stearicum (Stearic Acid) 586 

Oleum Theobromatis (Oil of Theobroma) 586 

Glycerinum (Glycerin) 587 

Petrolatum Molle (Soft Petrolatum) 589 

Petrolatum Liquidum (Liquid Petrolatum) 589 

Petrolatum Spissum (Hard Petrolatum) 589 

Saccharum (Sugar) 590 

Mel (Honey) 591 

Saccharum Lactis (Sugar of Milk) ... 591 

Saccharin 59 l 

Order IV. Protectants and Absorbents 592 

Protectants 592 

Calcii Sulphas Exsiccatus (Dried Calcium Sulphate) 592 

Liquor Sodii Silicatis (Solution of Sodium Silicate) 593 

Liquor Gutta-Perchae (Solution of Gutta-Percha) 593 

Elastica (India Rubber or Caoutchouc) 593 

Resina (Resin, Colophony) 594 

Ichthyocolla (Isinglass) 594 

Rubber Adhesive Plaster 594 

Pyroxylinum (Pyroxylin) 595 

Collodium (Collodion) 595 

Collodium Flexile (Flexible Collodion) 595 

Collodium Stypticum (Styptic Collodion) 596 

Lycopodium 59^ 

Absorbents ' 59 6 

Carbo Ligni (Charcoal) 59^ 

Carbo Animalis (Animal Charcoal) 59^ 

Gossypium Purificatum (Purified Cotton) 597 

Spongia (Sponge) 59^ 



24 CONTENTS. 

PAGE 

Bran (Furfur) 598 

Order V. Coloring Agents 598 

Crocus (Saffron) 598 

Santalum Rubrum (Red Saunders) 599 

Coccus (Cochineal) 599 

Order VI. Anthelmintics 599 

Spigelia (Pinkroot) 600 

Chenopodium 602 

Santonica 603 

Santoninura 603 

Aspidium (Male Fern) 604 

Granatum (Pomegranate) 605 

Oleum Terebinthinae (Oil of Turpentine) 606 

Calomel 606 

Cusso (Kousso) 606 

Kamala (Formerly Rottlera) 607 

Pepo (Pumpkin Seed) 607 

Appendix I. Dietary for the Sick 609 

II. Signs and Abbreviations 612 

III. Table of Doses for Adults 615 

IV. Solutions for Hypodermic Use 636 

V. Strength of Alcoholic Liquors • . .... 637 

VI. Table of Parasites 638 

VII. List of New Remedies Under Trial .... 647 

Index of Diseases and Remedies 65 1 

Index to Contents 683 



Materia Medica and Therapeutics. 



I. The agents employed in the treatment of diseases are denomi- 
nated Remedies, and the branch of medicine which is devoted to their 
consideration is termed Materia Medica. Remedies may be divided 
into Hygienic, Mechanical, Imponderable, and Pharmacological 
agents. 

II. By Therapeutics is meant the application of remedies to the 
treatment of disease. It includes, in a broad sense, the use of remedial 
measures of all sorts — as climate, diet, baths, nursing, clothing, mas- 
sage, electricity, and physical exercise. Therapeutics, as considered 
in this work, may be divided into (i) rational and (2) empirical. 

1. By rational therapeutics is meant the administration of a remedy 
for therapeutical purposes based upon what is actually known of its 
physiological action. Thus, it is given beforehand with a definite idea 
of what it is to accomplish, and consequently, when so taken, antago- 
nizes a particular pathological condition with some degree of certainty. 
The use of digitalis in the relief of mitral regurgitation is an example 
of rational therapeutics, since this drug is well known to prolong the 
diastole, and energize the systole of the heart, thus more completely 
filling and emptying its cavities, and consequently overcoming the 
obstruction to the regular flow of the blood : hence its exhibition is 
indicated on rational grounds. 

2. Empirical therapeutics consists in the administration of remedies 
at haphazard, because previous experience ha c demonstrated their 
efficiency in certain affections, while the explanation as to their action 
remains totally obscure. The exhibition of opium as an anodyne 
and hypnotic is an example of empirical therapy. That it deadens 
pain and induces sleep is well understood; but the way in which it 
does so is completely unknown. The majority of drugs are employed 
empirically. 

Hygienic Remedies are usually treated of in works specially 
devoted to the subject. 

25 



•y, MATERIA MEDICA AND THERAPEUTICS. 



PART I. 

MECHANICAL REMEDIES. 

Mechanical Remedies belong chiefly to Surgery. A few agents 
of this class being, however, employed in the practice of medicine, are 
included in the Materia Medica. They are Blood-letting (general 
and local), Setons, Issues, Bandages, Friction, Acupuncture, Aspi- 
ration, Gastric lavage, and the Stomach pump. 

1. General Bloodletting is performed principally by venesection ox 
phlebotomy, which is usually practised on the median-cephalic or 
basilic veins of the arm — sometimes also on the external jugular and 
other veins. From the veins at the elbow it is done by passing a liga- 
ture above the points selected, the patient being in the sitting posture, 
and making an incision in the most prominent vein, ample enough to 
permit fSij-iij of blood to escape rjer minute, and allowing it to flow 
until syncope approaches. To stop the flow, remove the ligature, 
apply a compress, and place the patient in the recumbent posture. 
Arteriotomy is occasionally resorted to, on the temporal artery, in 
cerebral affections. 

Medicinal Uses. — Blood-letting is employed to moderate vascular 
excitement, reduce inflammatory action, alter the quality of the blood 
(diminishing the proportion of fibrin, albumen and salts), relieve conges- 
tion, allay spasm and pain, relax the muscular system, promote absorp- 
tion, arrest haemorrhage, remove stasis, and prevent cell proliferation 
and inflarnmatory effusions, and for these purposes it has long been 
considered a valuable therapeutical resource. So powerful and ex- 
hausting an agent is, however, always to be resorted to with caution 
and discrimination; is not to be unduly repeated, even in inflammatory 
cases ; and is seldom or never proper in disease of a typhoid tendency, 
or where a tubercular diathesis is suspected, or in extreme infancy and 
old age. It is indicated in inflammations and conditions of sthenic 
type, occurring in robust adults, and accompanied by a full, bounding, 
tense pulse, and should only be resorted to early in the case, before 
inflammatory effusions have taken place. Under these circumstances 
it may be of service to abort apoplexy or pneumonia, and to relieve 



MECHANICAL REMEDIES. 27 

puerperal eclampsia, and urcemic convulsions. In apoplexy blood-letting 
is particularly serviceable with flushed face, pulsating carotids, hyper- 
trophy of the left ventricle, and accentuated aortic second sound. 

2. The Local Abstraction of Blood is practised by means of leeches, 
cups, and scarifications. When a leech is applied between the inflamed 
area and the heart, the blood-current is accelerated, stasis removed or 
prevented, as are also the migration of cells and the effusion of serum. 
Scarifications produce the same results in a less degree, and also give 
vent to effused fluids. The leech (hirudo) is an annulated aquatic 
worm, with a flattened body, tapering toward each end, and termin- 
ating in circular flattened disks, which is found throughout Europe, 
America, and India. The European leech (li. viedicinalis, termed also 
sanguisuga officinalis}, is of a blackish or grayish-green color on the 
back, from two to three or four inches in length, and is characterized 
by six longitudinal dorsal ferruginous stripes, the four lateral ones 
being interrupted or tessellated with black spots. It draws about f§ss. 
The. American leech (h. decora) is usually from two to three inches 
long, and is of a deep, green color, with three longitudinal dorsal rows 
or square spots. Both the imported and indigenous leech are em- 
ployed in this country, but the latter makes a smaller incision, and is 
preferable in infantile cases. It takes about f5j. As leech-bites make 
scars, they should be cautiously applied over an exposed part — as the 
female face ; nor should they be used where there is much loose con- 
nective tissue, as the scrotum and eyelid ; over a superficial vessel or 
nerve ; seldom over the seat of morbid action, nor in the vicinity of 
locally infected wounds, as venereal ulcers. When the discharge of 
blood from leech-bites is excessive, it may be arrested by pressure, 
compresses of lint, the application of alum, creosote, solution of ferric 
subsulphate, and other styptics, or by cauterizing the wound with silver 
nitrate or a red-hot probe ; and if these means fail, the lips of the 
wound may be sutured. 

When blood is drawn by leeches, its continuous flow can be pro- 
moted by the application of warm fomentations to the wounds. 

In the operation of cupping, cupping-glasses and a scarificator are 
employed. The removal of atmospheric pressure, by the application 
of glasses partially exhausted of air, which may be done by igniting a 
little alcohol in each cup immediately before its application, produces a 
determination of blood to the capillaries of a part, which is afterward 
readily drawn by scarification. When blood is not abstracted the 
operation is termed dry cupping, and is a valuable revulsive agent- 



:> MATERIA MEDICA AXD THERAPEUTICS. 

The topical abstraction of blood by leeches and -Qut-cups combines the 
advantages of depletion and revulsion. Cups are generally preferable 
in internal inflammations, from their more decided revulsive influence. 

Medicinal Uses. — Both the dry and wet cups are employed in a 
wi»le ranee of affections in which the local abstraction of blood and a 
revulsive action may seem necessary to influence distant organs, as in 
the first stage of acute Bright 's disease, as well as in the chronic forms ; 
here the cups should be applied over the renal region. Wet cups are 
also of service in urcemic convulsions and urcemia. Leeches are em- 
ployed in the early stages of external inflammations, where cups would 
obviously be inadmissible, and in infantile cases. They are applicable 
to the treatment of forming abscess, adenitis and bubo, to antagonize con- 
gestion, stasis and pressure, applied near or over the affected part or 
glands; to relieve metritis and endometritis (to cervix), keratitis (temple), 
myelitis (spine), and myringitis (mastoid). In the early stages of peri- 
carditis they may be advantageously applied to the praecordium. 

Scarifications are slight incisions (as with a scalpel) made upon 
inflamed parts *to relieve the engorged capillary vessels, acting by 
giving vent to blood and serum. They are sometimes employed with 
benefit in acute tonsillitis and in conjunctivitis with much chemosis and 
swelling ; also, when there is an acute inflammation going on under 
or in the skin. Scarifications relieve the preputial cedema of balanitis. 
They are likewise serviceable in the treatment of acne indurata by 
puncture, and should be followed by a stimulating lotion. Made upon 
the tympanic membrane and avoiding perforation, a few cuts afford 
relief in acute myringitis. As scarifications give vent to effused fluids, 
they may be used to let out the superficial dropsy of chronic Bright 's 
disease. 

3. Setons (setaced) and Issues (fonticuli) were employed when a 
permanent counter-irritant effect was desired. They are now rarely 
used. 

4. Bandages are employed, in the practice of medicine, to promote 
the absorption of dropsical effusions and solid inflammatory exudations. 
For the same purpose strips of adhesive plaster may be applied to the 
chest, in chronic pleurisy and empyema, in the manner in which they 
are employed in the treatment of fractured ribs. Strapping the side 
often relieves pleurodynia by affording rest to the parts. The elastic 
bandage is used to promote the absorption of fluid in diseases of the 
bursa. 

5. Frictions are used as revellents and as local stimulants. Thev 



MECHANICAL REMEDIES. 29 

may be employed either with the dry hand, or with horse-hair gloves, 
or with liniments. The latter, applied with a sponge, are serviceable 
in lumbago, sciatica, chronic rheumatism, rheumatic arthritis, and 
affections of the joints ; rubbed on the chest in acute bronchitis, they 
often afford relief. As a local stimulus in anidrosis, frictions tend to 
re-establish the secretion of the sweat. 

6. Acupuncture consists in the introduction into the body of fine, 
well-polished, sharp-pointed needles ; they are introduced by a rapid 
rotary motion. This is a remedy occasionally used, though a painful 
one, in chronic rheumatism, neuralgia, and paralysis. Introduced 
within the muscles, and retained five to ten minutes in lumbago, they 
often afford relief. The needles should be sterilized. 

7. Pneumatic Aspiration is the employment of an instrument termed 
an Aspirator (invented by Dieulafoy) for the removal by suction of 
pathological fluids. 

The aspirator consists of: — 

1. A glass-bottle or reservoir, A, mounted with a two-way stop- 

cock, B, and having an opening at the bottom for the inser- 
tion of the tube, C. 

2. An exhausting syringe, D, with elastic connecting-tube, H. 

3. A tubular needle, E, to be attached to the reservoir by an india- 

rubber tube, F. 

A syringe and stop-cock for injecting astringents or other fluid is 
supplied if desired. The stop-cock is, in such cases, fixed to the tube 
F at its junction with the stop-cock B. Thus the tube can be detached 
from the aspirator without any chance of air entering the morbid 
cavity. 

Directions for Use. — Adjust the aspirator as figured in the dia- 
gram, with the stop-cock B turned vertically, that is, open to the 
bottle; close the stop-cock in the tube C, and form a vacuum by a few 
upward and downward movements of the piston of the exhausting 
syringe D. 

Insert one of the needles beyond the two eyes, attach tube F to it, 
turn the stop-cock B toward the needle, namely, horizontally, and con- 
tinue the insertion of the needle until fluid is seen to flow through the 
short glass-tube G into the reservoir. 

To empty the latter, turn the stop-cock B vertically, detach the 
syringe-tube, and open the stop-cock in the tube C. 

The presence of fluid having been established by the use of one of 



30 



MATERIA ME PICA AND THERAPEUTICS. 




MECHANICAL REMEDIES. 31 

the fine needles, it is recommended, for more quickly emptying the 
cavity, to use one of the larger needles or trocars. 

The introduction of the needle into the tissues requires some pre- 
cautions. In place of endeavoring to penetrate by pressure, as with an 
ordinary trocar, it is preferable to combine pressure with rotation, by 
taking the needle in the forefinger and thumb and rolling it between 
them. Such a manoeuvre is rendered necessary by the extreme fine- 
ness of the needle, which would be liable to bend or twist if driven in 
by direct pressure. Before using a needle it is well to be assured of 
its permeability. 

Aspiration has been employed with safety and success, when other 
means have failed, in the removal of intrathoracic effusions, as in chronic 
pleurisy, empyema, and pericarditis ; of the fluid of hydrocephalus, spina 
bifida, ascites, hydrothorax, cysts, abscess of the liver, hydrocele, syno- 
vitis ; diseases of the bur see, and dropsical effusions generally, as those 
of chronic Bright 's disease. It is also applicable to the diagnosis and 
treatment of morbid fluids. Its use, too 7 avoids the formation of a dis- 
figuring scar, as in the withdrawal of pus from a bubo. 

Aspiration should be done under strict antiseptic precautions. 

8. Gastric Lavage, or the washing out of the stomach, which can be 
accomplished either with a soft, flexible rubber-tube and funnel, or, some 
special apparatus, is employed in part for the purpose of examining the 
contents of the stomach. Medicinally, it is of service in chronic gas- 
tritis, characterized by much mucus. Tepid water should be used, to 
which may be added a little sodic bicarbonate ; or, if fermentation be 
going on, three per-cent. of boric acid. Once, daily, is often enough, — 
the morning, and on an empty stomach, being the best time. Lavage is, 
sometimes, beneficial in gastric ulcer, practised just before feeding, when 
the stomach is irritable, and will not bear food. In dilatation of the 
stomach, according to Welsh, lavage accomplishes much by the removal 
of mucus, and stagnating and fermenting matters which distend the 
organ and hinder digestion. 

9. The Stomach Pump. — This consists of a forcing or double-acting 
syringe, to the bottom and nozzle of which flexible tubes can be at- 
tached. The stomach-tube should be well warmed and softened in hot 
water, and introduced without violence. The stomach-pump is em- 
ployed to convey fluids to the stomach when deglutition is hindered, as 
in constriction of the gullet, or to withdraw the contents in cases of 
poisoning. 



32 MATERIA MEDIC A AND THERAPEUTICS. 

PART II. 

IMPONDERABLE REMEDIES. 

Under this head are included Light, Heat, Cold, Electricity, 
and Massage. 

1. Light [Lux) exercises an important influence in the organized 
world as a vivifying stimulus. It is useful as a therapeutic agent, in 
diseases dependent on imperfect nutrition and sanguification ; and the 
exposure of the surface of the body to its action, as far as nudity is com- 
patible with proper warmth, promotes the regular development and 
strength of the organs. On the other hand, in many diseases the ac- 
tion of light is injurious, and darkness is resorted to as a sedative and 
tranquillizing agent. Protection from light is thought desirable in the 
ripening stage of the papules of small-pox, to prevent pitting. 

2. Heat {Calor). — Physiological Effects. — Applied to the human 
system in moderate amount, heat acts, both locally and generally, as a 
stimulant. In whatever way exhibited, it elevates the temperature of 
the parts to which applied, or that of the body in its entity. Dry 
heat, at first, warms and reddens the skin, and, if the degree of heat be 
sufficiently intense, destruction of the tissues, vitality and organization 
follows, varying in extent, with the temperature of the applicator, and 
length of contact. The application of the actual cautery, exemplifies 
the effect of high heat. Hot water, as a bath, or local application, 
dilates the superficial vessels, cleanses the part, favors diaphoresis, and, 
if very hot, reddens the skin. Prolonged immersion in a hot bath is 
enervating ; used for a short period, it is a powerful relaxant of the 
muscular system, especially of the involuntary muscles ; hence, its value 
in colic and hernia. Hot water is peculiarly acceptable and soothing 
to the nasal and buccal mucous membranes. 

The application of warm water to the skin is soothing, and it 
diminishes cutaneous irritability. The water of a warm bath is not ab- 
sorbed by the skin, though certain medicaments dissolved in it are ap- 
propriated by the economy through this channel; corrosive sublimate 
and iodine, for example. 

Contraindications. — All baths are unsuitable for the asthenic, and 
are to be avoided by those affected with fatty heart, and who have a 
tendency toward apoplexy. 



IMPONDERABLE REMEDIES. 33 

Medicinal Uses. — Heat is employed as an excitant and revulsive, 
and systemic restorative, by means of hot bottles, hot bricks, hot foot- 
bath, elastic bags containing hot water, poultices and fomentations, 
and stupes or compresses wrung out of boiling water. The algid stage 
of collapse is antagonized by hot bottles, bricks and blankets ; in facial 
palsy when due to cold, heat should be applied to the affected side of the 
head ; inflamed and painful parts may be treated by hot water in 
elastic bags, or heat in the form of poultices (q. v.) or fomentations. 
Hot water introduced into the auditory canal will often stop the pain 
of that symptomatic condition known as ear-ache ; injected into the 
uterus it is a method of treatment sometimes of value in endometritis, 
and is likewise occasionally used in metritis ; and as an injection in 
female gonorrhoea. Hot compresses form a soothing application to the 
parotid glands in mumps. As a general application heat is resorted to 
in the form of the water-bath and vapor-bath. The warm bath, at a 
temperature of from 92 to 98 F. is used as a relaxant in dislocations, 
hernia, spasm, infantile convulsions t croup-, etc., and also for its action 
on the joints in rheumatic, and upon the skin, in chronic cutaneous 
affections — rheumatic arthritis and anidrosis, for example. The hot 
bath, which may be either the plunge, hip, or sitz, has a temperature of 
from 98 to 112 F., or even higher, and is a powerful excitant in cases 
of exhaustion and asphyxia ; it alleviates the strangury of acute cystitis 
and gonorrhoea, and is employed also in paralysis, chronic rheu- 
matism , and rheumatic arthritis. Hot water, introduced with a David- 
son's syringe, is an efficient styptic in uterine hemorrhage ; injected 
into the vagina before an operation on the perineum or cervix, or 
applied to wounds during a surgical operation, it is a good means of 
avoiding haemorrhage. Hot water (f^ij) is frequently forced into the 
blad.der, in chronic cystitis, for the purpose of washing it out ; and by 
Milton is injected into the urethra in gonorrhoea, as hot as can be 
borne. Warm water is a most efficacious and soothing douche in the 
removal of mucus and exudates from the nostrils in chronic nasal 
catarrh, often well combined with carbolic acid, or borax. In amenor- 
rhoea hot sitz-baths, or foot-baths, with a little mustard added, taken a 
few days before the expected period, are sometimes efficacious in re- 
establishing the menstrual flow, and the application of a hot water-bag 
to the spine or abdomen usually relieves the pain in dysmenorrhea. 
The chafing of tender feet may be avoided by soaking them in hot 
water containing a small lump of potassium nitrate. Immersion in the 
hot bath is one of the best means of alleviating the severe pain attend- 
3 



34 MATERIA MED1CA AND THERAPEUTICS. 

ing the passage of biliary and renal calculi, to prevent an attack of 
laryngismus striduluSyto facilitate the urinary flow combined with a full 
dose of opium in retention, and lastly as the plunge or hip-bath in the man- 
agement of endometritis. Tepid alkaline baths are serviceable to soften 
and remove the crusts and scales of various cutaneous affections, for 
instance, ecthyma, prickly heat and psoriasis, to which may be added a 
little carbolic acid. Hot baths are also useful in promoting the elimi- 
nation of mineral poisons, as in colica pictonnm. The hot-air bath, at a 
temperature of from 98 to 130 F., is useful as an excitant, diaphoretic 
and revellent, and is employed in cases of internal congestion, to pro- 
duce vicarious action from the skin, where the secretion from other 
organs, as the kidneys, is more or less suspended, notably in chronic 
Bright s disease, and in rheumatic and cutaneous affections, particularly 
that of anidrosis, for the purpose of re-establishing the secretion of the 
sweat. 

When desirable to employ riot baths for a prolonged period, con- 
joined with a change of climate and scene, those of the Hot Springs, 
Arkansas ; Las Vegas, New Mexico ; and Bath County Hot Springs, 
Virginia, should not be lost sight of. These waters are often bene- 
ficial when other measures have failed in gout, chronic rheumatism, 
stiffness of the joints, rheumatic arthritis, paralysis, without organic 
lesion, secondary and tertiary syphilis and neuralgia. They render aid, 
too, in such cutaneous affections as lichen, psoriasis, phthiriasis, and 
chronic eczema. The temperature of the Arkansas Springs varies 
from 93 to 150 Fahr., and there are 57 springs from which the 
thermal waters flow in abundance. They contain small quantities of 
mineral matter, but only to the extent of gr. 7^ to the gallon, com- 
posed chiefly of calcium carbonate and silica. The temperature of 
the Las Vegas Springs ranges from 123 to 130 Fahr.; the mineral 
constituents of this spring being principally sodium chloride and 
sulphate. The Bath Springs vary from ioo° to 106 Fahr. Experi- 
ence has proven that the waters of the Hot Springs of Arkansas are 
injurious in maladies of the brain, heart and lungs. 

The destructive agency of heat is resorted to for the purpose of 
vesication, as by the application to the skin of the metallic plate heated 
to 212 by immersion in boiling-water; and of cauterization, by the 
employment of red-hot iron. Hot iron (known as the actual cautery) 
is used chiefly as a styptic, but also as a revulsive as when applied to 
the spine in spinal irritation. It is sometimes employed in severe 
under ether. When employed as a haemostatic it 



IMPONDERABLE REMEDIES. 35 

should be at a cherry-red heat, otherwise the vessels will be so 
thoroughly burned as to form an imperfect clot; for revulsive or 
counter-irritant purposes it should be at white heat. 

3. Cold (Frigus). — Physiological Effects. — The application of 
cold to living bodies produces a reduction of the temperature and 
volume of the parts by the absorption of heat therefrom, loss of sensa- 
tion, with contraction of the cutaneous vessels and other tissues, and 
suspension of the secretions and exhalations ; hence it is antipyretic, 
antiphlogistic and analgesic. The respiratory and cardiac movements 
are at first accelerated ; but prolonged exposure to cold, varying in 
degree with the body-vigor, causes retardation of both functions. The 
effect of cold upon the skin, if the form be water, is to moisten and 
cleanse it, and also to excite into contraction the dermal erectores 
pilorum muscles, producing cutaneous roughness and redness, known 
as " goose flesh." The application of excessive or prolonged cold is 
followed by torpor and death of the parts, or of the entire economy. 
When it is applied in moderation and for a short period, reaction 
generally takes place, with a return and even increase in temperature, 
volume, color and sensibility. Should, however, the individual be in 
a condition of physical depression, no such reaction ensues, hence 
cold baths are only suitable for the vigorous. 

Within the stomach cold water or ice produces an antipyretic 
effect by abstracting heat from the economy, the expended caloric 
becoming latent. 

Contraindications. — Cold baths are to be shunned if followed 
by chilliness, and by those who have a flabby heart or a tendency to 
apoplexy. 

Medicinal Uses. — Cold is employed therapeutically, with a view 
to both its primary and secondary effects. The primary action of cold 
is used: I. To lessen vascular and nervous excitement and preter- 
natural heat, as by the use of cold lotions and spongings m fevers, the 
ice-cap in cerebral affections, the shower-bath in insanity, the bladder 
filled with ice to the spine in epilepsy, the ether-spray to the spine in 
chorea, etc. 2. To constringe the tissues, promote the coagulation of 
the blood and lessen the volume of parts ; hence the local application 
of ice- or cold water to abate inflammation and check hemorrhage. 
3. To produce local anesthesia in surgical operations, by means of a 
freezing mixture topically applied, as with rhigolene (q.v.). 

The secondary effects of cold are obtained by the employment of 
a less intense degree of cold. They are resorted to : 1. To invigorate 



36 MATERIA MEDICA AND THERAPEUTICS. 

the system, as with the cold shower-bath and plunge-bath. 2. To 
rouse the system, as by cold affusions in coma, asphyxia, syncope, and 
the narcotism from opium, chloroform, hydrocyanic acid, alcohol, etc. 
3. In spasmodic diseases, as laryngismus stridulus, chorea, etc. 4. 
To recall the vital properties to frost-bitten parts, as chilblain. 5. To 
effect local excitation, as by the application of the cold douche to 
rheumatic and paralyzed limbs. 

The cold bath, or packing in a cold wet-sheet, at 6o°-70° F., is 
employed with much advantage in sunstroke, and in fevers where the 
temperature of the body is very high (i02°-3° F.), as scarlet fever, 
typhoid fever, acute rheumatism, and, generally, to reduce excessive 
hyperpyrexia. When the cold wet-sheet is employed, it should be 
well wrung out of cold water, wrapped round the patient, and all 
enveloped in a thick blanket. 

In Osier's Clinic, when the temperature rises above 102. 5 ° F. in 
typhoid fever, particularly if there be marked nervous symptoms, the 
patient is placed in a bath at yo° F., which is wheeled to the bed-side 
in which he or she is kept 15-20 minutes, then wrapped in a dry sheet 
and covered with a blanket. Water enough is used to cover the body 
to the neck. The head is sponged, and if there be stupor, cold water 
is poured on the head. Complaints as to shivering and blueness are 
sure to follow. After the bath food and a stimulant are given. Peri- 
tonitis and haemorrhage are contraindications to the bath. 

The ice-bag is sometimes applied along the spine in convulsive 
diseases, as epilepsy, tetanus and infantile convidsions, as well as spinal 
irritation, cerebrospinal meningitis and myelitis, and over the kidneys 
in hcematuria. Applied to the back of the neck in acute tonsillitis 
when there is much pain, fever and sweating, it is often serviceable. 
The ice-bag does good, too, when laid over the prsecordium m. peri- 
carditis before effusion, by quieting cardiac action and retarding 
inflammation. It is also useful in exophthalmic goitre placed over the 
cardiac region to quiet palpitation. In typhlitis the ice-bag is useful 
at the onset of the symptoms, applied over the right iliac region. 

Compresses wrung out of cold water, or the ice-bag, are efficient 
local applications in relieving pain, as when applied to the head in 
cerebral hyperemia and meningitis, to the parotid glands in mumps, 
about the joints of chronic rheumatism, and to antagonize the inflam- 
mation of sprains and synovitis. The ice-bag is applied over the 
praecordium to quiet the heart in endocarditis. Bathing the eyes 
frequently in cold water will allay photophobia as that of keratitis and 



IMPONDERABLE REMEDIES. 37 

conjunctivitis. Compresses saturated with ice-cold water are useful 
topical applications in the first stage of inflammation of high grade 
about the eye, as conjunctivitis of gonorrhoeal origin. 

Cold liquids and ice are taken into the stomach as refrigerants in 
fevers, and ice is melted in the mouth to allay the thirst of cholera, 
cholera infantum and peritonitis. Cracked ice, slowly swallowed, is 
employed against the bleeding of hcematemesis , to allay nausea and 
vomiting, and the sucking of cracked ice will relieve the heat and 
sensitiveness of the mouth in simple stomatitis. Cold liquids are 
introduced into the rectum and vagina to check haemorrhage and 
allay irritation ; and cold water injected into the impregnated uterus, 
is among the most certain means of inducing premature delivery. 
Chordee may be checked by the application of a bottle of ice-cold 
water to the perineum. 

4. Electricity* (Electricitas), from fjAexrpov, amber. " Electricity 
is now regarded as a force co-related to the other great forces of 
nature — heat, light, etc., — and, like them, is simply a mode of motion 
— a force of vibration." (Beard and Rockwell.) 

For medical purposes electricity is obtained from three sources : — 

i. Friction, Static or Franklinic electricity. 

2. Galvanic electricity. 

3. Faradic, Induced, Magneto-Electric or Electro-Magnetic 
electricity. 

Friction Electricity is obtained by friction from a glass-cylinder 
or plate, and by induction (the Holtz machine and its modifications). 
The prime conductor of an electrical machine furnishes positive, and the 
rubber, negative electricity. Static electricity, by Morton's method, 
causes muscular contractions with but little pain, resembling those of 
the Faradic battery. If a finger be presented to the prime conductor 
of an induction machine, a spark will follow, and simultaneously a 
stinging pain be felt in the part; the spark only passes when the resist- 
ance of the medium (air) between the finger and prime conductor is 
overcome. Sparks may be obtained from the clothing of a person 
placed on an insulated platform and connected with the prime con- 
ductor of an induction apparatus ; after being charged these may be 
drawn from the body, and are accompanied by a report and stinging 
sensation. 

*Ganot's Physics; Med. Electricity, De Watteville; Essentials of Med. Electricity, 
Stewart and Lawrence, 1892. 



33 MATERIA MEDIC A AND THERAPEUTICS. 

Friction electricity may be applied in three modes : — 
i. By the electric bath, when the patient, placed upon an insulated 
stool and connected with the prime conductor of an electrical machine, 
is charged with electricity, positive from the prime conductor, negative 
from the rubber. 

2. By a spark to a particular spot; or, 

3. A shock through a charged Leyden jar may be directed through 
the part which it is desired to affect; it is akin to lightning and may be 
of great power. 

Galvanism is that form of electricity which is developed by 
chemical decomposition, and is known as the continuous, voltaic, or 
battery current. To produce galvanism two metallic plates are im- 
mersed in a solution which acts chemically to a greater extent on one 
than the other, the one acted on the most (commonly zinc), being the 
generating plate, the other (copper), the conducting plate. Gal- 
vanic action only begins when the plates are connected by a wire or 
other conductor, — the circuit' is then completed or closed; when the 
plates are disconnected, it is said to be opened. When closed 
the current flows from the plate most acted on by the solution to the 
other, and thence back through the connecting wire to the first 
plate. A collection of galvanic cells united is called a battery. Dilute 
H 2 S0 4 is the fluid usually employed. By the action of the acid on the 
zinc plate, the fluid in the cell eventually becomes a saturated solution 
of zinc sulphate which is deposited on the copper-plate slowly, while 
the liberated hydrogen gas, collecting as bubbles on the copper-plate, 
hinders the passage of the current. Consequently galvanic action 
from single-fluid cells is not constant ; to obtain this, two-fluid cells 
with certain mechanical arrangements are employed to secure a con- 
stant current. Daniell's and Le Clanche's arrangements of cells give 
a constant current. 

Galvanic action is characterized by relatively low intensity of action, 
great dispersive power (Helmholtz), and being developed in consider- 
able quantity, it produces chemical and thermic results that are not 
reached by the friction electricity. When the current of any form of 
electricity is applied to the body, it passes between the electrodes 
along the line of least resistance, which is for the most part a direct 
one. The continuous flow of the galvanic current through a motor 
nerve, unless the current be strong, is not followed by contractions of 
the muscles supplied by the nerve. Such contractions are only 
induced when the current is closed or broken. Upon the involuntary 



IMPONDERABLE REMEDIES. 39 

muscles, as the intestinal, the galvanic current causes slow and con- 
tinuous contractions during the passage of the current. Hence the 
rationale of the use of galvanic electricity for the purpose of increasing 
peristaltic movements in constipation. The galvanic current stimulates 
the sensory nerves, causing a prickly sensation, the point of contact of 
the cathode with the skin being felt the most, and at the same time an 
increased flow of blood to the part is induced. When the current is 
much increased the sensation passes into a burning feeling which after 
a time diminishes at the anode. Upon the gustatory nerve the 
passage of the current through the tongue produces a metallic taste. 
The precise effect of galvanism upon the brain is not well understood, 
but it evidently penetrates the cerebral substance, for when the posi- 
tive electrode is applied to the occiput, and the negative upon the 
forehead, an increased blood-supply to the head follows. Should the 
current be of sufficient strength, vertigo will ensue. Galvanism of 
the cord induces muscular contractions, hence it is inferred that the 
current penetrates within its substance, at least as far as the motor- 
cells. 

Faradization, or Induced electricity, is applied by means of 
electro-magnetic machines, their principle depending on the passage 
of a battery-current through an insulated wire-helix (primary coil) 
wrapped round a soft iron-bar, which becomes magnetic by induction. 
Around this helix a fine insulated wire is coiled (secondary coil), 
which has no connection with the battery or primary helix, and which 
receives electricity by induction from the latter. Closure of the 
current magnetizes the bar, which, in turn, attracts the rheotome, thus 
breaking the flow, the bar then becomes demagnetized, the rheotome 
flies back by its own elasticity, and in this way an interrupted current 
is obtained. The polarity of the induced current changes with each 
make and break of the circuit, and of course is inconstant, because its 
direction is constantly alternating ; hence no chemical action is set up. 
The faradic current causes contractions of the muscles supplied by 
the nerve stimulated which are stronger succeeding the opening than 
the closure of the current. If the interruptions be rapid enough, they 
cause apparently continuous muscular contractions. 

The primary current is taken from the inner helix ; the secondary 
from the outer. The shocks from the primary are much the weaker. 
The electrodes are the means by which the positive and negative 
electricity emerge from the battery ; the positive pole or anode, being 
connected with the negative element, and the negative pole, or cathode, 



40 - MATERIA MEDICA AND THERAPEUTICS. 

with the positive element. Before use, the electrodes should be 
moistened to increase their conductivity, as the skin is a bad conductor. 
The larger the electrode the greater will be the conductivity of the 
skin ; on the other hand, to electrilize the skin alone, small metal elec- 
trodes should be used. Magneto-electricity is inferior in chemical and 
thermal influence to galvanism, but it produces more marked muscular 
contractions, and a more decided action on the sensory and motor- 
nerves. It has been shown by DuBois-Reymond that it is not the sum 
total of the density of the current passing through a motor-nerve that 
stimulates it, but that such stimulation is due to change of density. 
Now the faradic current is made up of numerous currents of short 
duration, which are closed and opened at each swing of the vibrator; 
consequently the change of density is abrupt, and the more suddenly 
these changes take place, the stronger will be the muscular contrac- 
tions. Upon the involuntary muscles the faradic current produces 
slower and more continuous contractions than upon the voluntary, the 
slower the interruptions the more powerful the contractions. It is by 
this peculiar action of diminishing the size of muscular fibre, that 
faradization becomes so serviceable in reducing the dimensions of the 
uterus after parturition. Upon the sensory nerves the faradic current 
produces a prickly, smarting sensation with each break of the rheotome, 
varying in intensity with the strength of the current ; when excessive 
the system is said to be shocked. The brain-substance, as shown by 
Erb, is readily affected by galvanism from the exterior, for when the 
electrodes are applied to the mastoids, flashes of light and vertigo are 
experienced ; but, according to Althaus,the former phenomenon is due 
to excitation of the fifth nerve. 

Definitions. — The unit of measure of resistance is called an ohm ; 
the unit of measure of the electro-motor force is termed a volt ; the 
unit of measure of current-strength is the ampere. Electro-motor 
force is the force generated in the cup by chemical action. The electro- 
tonus is the influence of the galvanic current upon a motor-nerve at the 
point of contact of the electrodes. Anode is the positive, and cathode, 
the negative pole. A stabile application is one in which the electrodes 
are kept in a fixed position ; in a labile y they are shifted from point to 
point. Central galvanization is the application of the current through 
the sympathetic pneumogastrics and spinal cord, by the cathode at the 
sacrum and the anode to the forehead ; general faradization signifies 
the application to the entire body of the current, one pole to the feet, 
the other shifted about the body. An ascending current is one flowing 



IMPONDERABLE REMEDIES. 41 

from the periphery toward the nerve-centre ; a descending current Flows 
from the centre toward the periphery. Reaction of degeneration is the 
altered electric excitability in diseased muscle and nerve. Faradic or 
galvanic excitability is the muscular contraction caused by the faradic 
current or galvanic battery. Rheophore is an insulated copper-wire 
cord, by means of which the current may be conveyed through a 
current-controller. The result of the chemical action in a battery is 
the electric current, which flows from the positive (zinc) to the negative 
plate (copper) ; the poles are the extremities of the wires attached to 
each plate. A rheostat is a current-controller. 

Electrical Diagnosis. — Electricity is employed in medicine for 
diagnostic and therapeutic purposes. Thus, in the diagnosis of spinal 
paralysis : when a muscle is merely separated from the influence of the 
spinal cord by destruction of its nerve, or by destructive disease of the 
cord at the origin of its nerve, it loses its electric irritability to all forms 
of electric irritation. In such an investigation the reaction of both 
sides of the body should be contrasted. Diminution of electro-excita- 
bility is found in locomotor ataxia of long standing and in diseases 
affecting the white matter of the cord ; in transverse myelitis ; in spinal 
affections that come under the orthopaedic surgeon's hands ; and lastly 
in muscles out of use from fracture, chronic joint troubles, etc. In 
midtiple neuritis (alcoholic, for instance) all faradic excitability is often 
lost, the muscles contracting to galvanism only, so that to be respon- 
sive to a strong galvanic current in such a condition is almost pathog- 
nomonic of neuritis. In cerebral paralysis, on the other hand, there 
is no diminution in the contractility of the paralyzed muscle by the 
electric current, and there may be even an increase. In malingering, 
real may be distinguished from feigned paralysis, as, after railway 
accidents, faradization, by showing a marked difference in the con- 
tractility of the two sides, establishes the fact of an actual morbid 
condition. 

In recent hysterical paralysis the contractility of the muscles is 
unimpaired. 

The condition of dermal sensibility may be ascertained with the 
faradic brush. 

Medicinal Uses. — Electro-therapy remains as yet on a basis 
more or less unsatisfactory. As a general statement its effects are not 
called in till other means have failed, consequently it is often given in 
conditions which no measures could benefit. Still, when correctly 
applied and limited to suitable cases, it is incontestably an agent capa- 



42 MATERIA MEDICA AND THERAPEUTICS. 

ble of accomplishing much good. Electricity may be employed either 
to arouse or increase the action of a nerve or muscle, as in paralysis 
of sensation or of motion, to relieve the pain of the various neuralgia, 
and to counteract the spasm of torticollis. For the latter galvanism is 
mostly used, the positive pole being connected with a large plate-elec- 
trode which is placed over the spastic muscles, while the negative 
is applied over a neutral point in the median line of the body. It 
is chiefly available in cases of local or of purely functional palsy, 
as facial, and alcoholic paralysis, which are independent of central 
lesions ; or in lead palsy after the elimination of the lead from the 
system. In the latter condition, which usually affects the extensors of 
the wrist and fingers, a good plan of treatment is to apply one large 
flat electrode over the junction of the cervical and dorsal vertebrae, the 
other to the sternum. The current should be sent in both directions, 
and when the polarity is changed it should be weak at first. It may 
be necessary, too, to galvanize separately the palsied muscles. 

In the treatment of facial palsy the positive pole of the galvanic 
current is to be placed over the point of exit of the nerve below the ear, 
the negative on the terminal nerve-filaments, which should be applied 
labile to the motor-points about the face with a small electrode and the 
current interrupted frequently. It ought to be just strong enough to 
produce moderate contractions. Should these be readily obtained, the 
prognosis is good. Galvanism gives the most satisfactory results when 
the palsy is due to peripheral neuritis, caused, it may be, by an effusion 
into the nerve-sheath, the result of a blast of cold air upon the face. 

Lumbago, neuralgia, muscular and chronic rlieumatism, and mi- 
graine are frequently benefited by a course of electricity. For the 
relief of neuralgia* a good plan is to place the cathode over the origin 
of the diseased nerve, the anode to the seat of pain and a current of 
moderate power passed through for three or four minutes. Where 
there are distinct painful points the anode should be thoroughly ap- 
plied. Sudden interruptions of the current are to be avoided. If 
galvanism fail, the faradic current should be tried. While there are 
no positive indications as to choice of battery, Rockwell gives the 
following rule for making the selectipn : if pressure aggravate the 
pain, galvanism is indicated ; if not, faradism is the proper form. 

Opinions differ widely as to the value of electricity in locomotor 
ataxia, Osier and Dujardin-Beaumetz regarding it of little benefit; 

* Boston Medical and Surgical Journal ', 1890, p. 313, Morton Prince, M. D. 



IMPONDERABLE REMEDIES. 43 

Rockwell, on the other hand, says the disease may be relieved, but 
never cured by this agent. He advises direct application to the spine, 
a strong current, large electrodes applied to distant points, and general 
faradization for the relief of the " lightning-like pains." 

In the treatment of chronic rheumatism electricity is often suc- 
cessfully employed. Either of the three forms of current may be 
given. When the faradic battery is used, the current should be passed, 
gradually increased, through the seat of pain, two or three daily 
seances being allowable. If the galvanic form be the selection, the 
cathode should be applied to the painful spot. According to W. H. 
King, static electricity is the most successful in the relief of this af- 
fection. 

In migraine a current of medium strength should be passed from 
the nape of the neck to the epigastrium ; in addition, a longitudinal 
current is to be sent through the head by applying the anode to the 
forehead or eye-lids, the cathode to the occiput. The seances may last 
from five to ten minutes. The best that can be said in favor of elec- 
tricity in sick headache is that it is only palliative, rarely curative. If 
galvanism fail, the faradic current should be tried. 

Galvanism in exophthalmic goitre has been successfully given. Beard 
and Rockwell's method for electrilizing the sympathetics (central gal- 
vanization, q.v.), the usual points of application, is to place the cathode 
over the seventh cervical vertebrae, the anode to the auriculo-maxillary 
fossa, and with the latter stabile and labile applications are to be made 
at the fossa and along the inner edge of the sterno-mastoid muscle. 
After this has been accomplished, the anode is to take the place occu- 
pied by the cathode and the latter applied over the solar plexus, through 
which points a strong current is to be passed for one or two minutes. 

In writer's cramp, of recent origin, good results may be expected 
from galvanism, which should be employed in conjunction with mas- 
sage and gymnastic exercise. The anode is to be applied to the 
middle cervical vertebrae, and the cathode over the affected muscles, 
through which a current of moderate strength should be sent daily. 
The seances should last from five to fifteen minutes, care being taken 
to regulate the power of the current, for this as in other cases, to the 
needs and condition of the patient. 

For the relief of sciatica, an affection often so obstinate, various 
plans of electrization both by galvanism and faradism are in vogue. 
One is to apply the cathode at the origin of the nerve with stabile 
applications of the anode in the vicinity of the pain ; or two small 



44 MATERIA MEDICA AND THERAPEUTICS. 

electrodes may be used to pass the current at short range through 
segments of the affected parts of the sciatic nerve ; or a large anodal 
plate may be applied to the sacrum, and with the cathode the current 
successively sent along the nerve and its painful branches. Whatever 
be the plan adopted, it should be combined with suitable hygienic and 
medicinal measures. 

Though by no possible construction can electricity be regarded 
as a cathartic, yet by its peculiar excitant effect upon the involuntary 
muscular fibre it sets up peristaltic action, and so, often brings about an 
evacuation from the bowels ; hence it is advantageously applied for the 
relief of chronic constipation. Place one electrode at the anus, and with 
the other go over the abdomen, using a current as strong as can be 
borne, until intestinal peristalsis can be detected by applying the ear 
to the abdomen. The galvano-faradic is the best form, but the faradic 
will do. 

Sperjnatorrhcea, urinary incontinence , and impotence, when func- 
tional, are not infrequently amenable to relief by electrization. It 
may be employed by applying a large plate-electrode to the lumbar 
or sacral regions, and with a disk-electrode covered with soft sponge, 
make labile applications to the perineum, groins and genitals ; or the 
current may be passed through the urethra to the perineum by intro- 
ducing it with a Neuman sound-electrode, the bulb of which is 
brought into contact with the neck of the bladder. Moral treatment 
must not be lost sight of in the first-named affection. In impotence, 
should the testicles and penis be cold and relaxed, the current may be 
advantageously sent through them. 

During the attack of angina pectoris successful results have been 
obtained with the galvanic current by placing the anode over the 
precordial region and going over the sympathetics and spine from the 
occiput downward with the cathode. The current should be weak at 
first and gradually increased. 

The management of hysteria with electricity meets with varying 
success, but no method of treating this conditition will be of avail 
unless supported by appropriate moral influence. According to King 
static electricity yields the best results, perhaps due to the mental 
effect produced by the brilliant spark. Electricity with other measures 
enters into the Weir Mitchell plan of treating neurasthenic disorders 
(see p. 48). 

In cerebral anczmia faradization, one electrode the anode, brought 
in contact with the occiput and the cathode to the forehead, since 



IMPONDERABLE REMEDIES. 45 

experience proves, that passed in this way the current causes an in- 
creased supply of blood to the head, has frequently been successfully 
employed. Weak currents should at first be used, and the body 
generally may be advantageously galvanized. 

Faradization is often satisfactorily given in apoplexy, the current to 
be applied to the paralyzed muscles with galvanization to the damaged 
portion of the brain. The results are, however, quite uncertain. The 
time to begin the cerebral application will be about one month after 
the attack,* and it should not be persevered in beyond one week if 
no benefit be apparent. As the effect of the current upon the clot 
seems to be catalytic it may be passed through the brain in the 
direction where this is supposed to be located. The application of 
the positive pole should be mostly on the side of the lesion ; but 
precise rules have not yet been formulated as to where it is best 
applied. 

Faradization deserves mention as a galactagogne. If there be 
evident lack of development of the mammary glands, it should be 
begun before pregnancy. When given at any period the current is to 
be passed through the breasts for about ten minutes. General fara- 
dization with other measures may likewise be called in to induce 
lactation. 

But little can be said in favor of electricity in dermal therapeutics, 
though good results are claimed for it in chronic eczema (Rockwell), 
one pole of the galvanic current being applied to the nerve supplying 
the diseased part, and with the other labile applications are to be 
made to the eruption. In anemic and hysterical paralysis, as hyster- 
ical aphonia, static electricity is often very useful, and in amaurosis, 
under many circumstances, faradization will be of benefit. 

Electricity has also been prescribed as an emmenagogue, to produce 
uterine contraction in post-partum hemorrhage, one pole to the ab- 
domen over the uterus, the other to the lumbar region j in testing for 
life or death ; and to promote the biliary secretion. 

In the form of galvanism, one pole to the rectum, the other over 
the abdominal tumor, electricity is employed to destroy the fcetus in 
extra uterine pregnancy, provided fcetal life has not advanced too far. 
It has also been advantageously used to promote the absorption of in- 
durations and fibroid tumors. ,f 

*De "Watteville (loc. cit.). 

t See Electricity in Gynaecology, 1891, Grandin and Gunning; and Brooklyn Med. J., 
Ap'l., 1891. 



4o MATERIA MEDIC A AND THERAPEUTICS. 

Electrolysis. — "This is a term applied to the process of decom- 
posing substances by electricity." It is used with decided success to 
remove superfluous hairs from the face and other parts. Pitzer recom- 
mends the following procedure: an ordinary galvanic battery of 10-15 
cells is required, with a fine needle, which is attached to the negative 
pole. The needle is inserted within the hair follicle and the current 
closed with the positive electrode, causing a stinging sensation at the 
point of insertion; the hair should then be withdrawn with forceps; 
thirty to fifty hairs can be removed at one seance. 

Electrolysis has been used in the treatment of internal aneurism, 
but with a measure of success only. One or more needles connected 
with the positive pole are inserted within the sac in the hope of form- 
ing a clot by the ensuing electrolytic action of the current on the 
blood. The negative pole is to be applied to the shoulder, the cur- 
rent turned on slowly, and the seance should last about twenty min- 
utes. Statistics show that the smaller the artery the greater the 
chance of occlusion. The chief dangers are haemorrhage and the de- 
tachment and drifting into the blood of coagula. 

Galvaxo-cautery. — This is a method of cauterization in which a 
wire-loop or other suitable cauterant is heated by the galvanic current. 
Experiment has shown that the heat developed in a wire by a current 
is proportional to the squares of the quantity of electricity flowing 
through it and to the resistance of the wire. 

Platinum, on account of its great resisting power, is the kind of 
wire selected. The chief advantages of the galvano-cautery are : ( 1 ) easy 
application to inaccessible parts, (2) absence of haemorrhage, and (3) 
comparatively little pain. It is employed as a cauterant in various ways, 
as to stop hemorrhage during an operation, to remove the hypertrophied 
tissues in chronic nasal catarrh, as a counter-irritant about the joints of 
chronic and gonorrheal rheumatism, etc. 

5. Massage.* — This is a word derived from the Greek, iidaaco, I 
knead ; Arabic, mass, press softly. Massage has been in use by the 
ancients from time immemorial. It is now defined to mean a series of 
digital and manual movements applied to the body for therapeutic 
purposes, and by some authors is designated mechano-therapy. There 
are four kinds of movements in vogue, viz., Effleurage, Petrissage, Ta- 
potement, and Massage (L friction. The first consists in gentle centri- 

* Massage, Douglas Graham, 1893; Le Massage, Dr. G.Berne, 1894; Handbook of 
Massage, 1892, Kleen. 



IMPONDERABLE REMEDIES. 47 

petal palmar stroking of the surface; the second, of picking up and 
kneading the soft parts with the fingers ; the third, of percussion with 
the fingers, hands or knuckles ; the fourth, of elliptical frictions in 
narrow circles. 

The art or act of massaging consists in the suitable combination 
of these movements, and, in order to obtain their best therapeutical 
effects, should only be employed under medical advice, and adminis- 
tered by an expert. Inasmuch as action and reaction are equal, an in- 
dividual cannot massage himself; moreover, there is an extraneous 
mesmeric influence involved, so conducive to its effectual performance, 
that renders this impossible. 

Contraindications. — Kleen (Joe. cit.) gives the following, viz., 
syphilitic skin-diseases ; purulent and inflammatory dermal skin-pro- 
cesses, malignant tumors, and pregnancy (abdominal massage). 

Physiological Effects. — Massage produces a calming effect on 
the nervous system, stimulates the flow of the blood and lymph, thus 
removing waste products, affords gentle exercise to the muscles, 
facilitates absorption, and elevates the body temperature about i°. 
The number of red corpuscles,* in health, is increased by massage, 
and to a lesser degree their haemoglobin value. It does, in a word, 
contribute to restoring the body to health by arousing to renewed and 
normal activity all the vital processes, and, unlike internal medication, 
is not followed by reaction of whatever degree of severity. 

As to the length of time required to accomplish definite results with 
massage, Eccles | finds that in one month's massage a gain in strength, 
body-weight and appetite, with ability to sleep and work well, may be 
expected. Massage of the abdomen, according to Rubens-Hirsch- 
berg,J augments the quantity of the gastric juice, lessens dyspeptic 
pains, and increases the urinary flow. 

Even in health, after violent exercise, general friction of the body 
augments the vigor of the system, and consequently plays an impor- 
tant part in all methods of training. 

Medicinal Uses. — Massage is employed frequently with advan- 
tage in a variety of obstinate affections where other measures have 
proved unsuccessful as paralysis, writer's cramp, paraplegia, facial 
palsy, locomotor ataxia, chronic and gonorrheal rheumatism, rheumatic 
arthritis, lumbago, ancemia, sciatica, neurasthenia, cachexies and spinal 

* Am. J. Med. Sci., May, 1884, J- K. Mitchell, 

f The Practitioner, 1887, p. 401. 

% Bull. Gen. de Therapy Sept. 30th, 1887, p. 241. 



4$ MATERIA MEDIC A AND THERAPELTICS. 

irritation. In fact, whenever there is loss of power, stiffness or pain in 
an accessible part, massage will nearly always afford relief. In 
chronic rheumatism, as in other affections where its employment 
seems advisable, a combination of massage with electricity will often 
be of benefit. In all cases the duration and frequency of the seances 
must be left to the discretion of the physician, and regulated by the 
nature of the disease. 

Under this heading mention must be made of the Weir Mitchell 
treatment of neurasthenic disorders, particularly those forms of hysteria 
uncomplicated with hypochondriacal symptoms, ovarian or uterine 
disease, which, in addition to massage, consists of isolation, rest, over- 
feeding, and electricity; and also of the 

Swedish Movement cure, which is defined by Schreiber to consist 
" in presenting a resistance to the intended motion of the patient, either 
by the physician himself or by an assistant." 

In detail the Weir Mitchell treatment, which involves costly 
nursing and a separation from one's friends, for 6 weeks to 3 months, 
consists of four factors : the first, isolation, which must be complete, 
including the non-receipt or writing of letters. A bright nurse should 
have charge of the patient who must be confined to bed, not even 
being allowed to feed herself. To begin with, the diet must consist 
of skimmed milk (if needful peptonized) 4 oz. increased to 8 or 10 
every 2 hours. After a few days a chop and bread and butter may be 
added, slowly increasing to three full meals per diem, a portion of the 
milk being gradually displaced by some agreeable and pre-digested 
food. Under this plan a gain in weight is accomplished. After two 
to three days ol confinement gentle massage should be begun (gentle 
stroking). The electrical part is the least important ; it should consist 
of slow faradic movements sent all through the body. Later on the 
Swedish movements may be used to restore the patient to the full use 
of her muscles. 



PHARMACOLOGICAL REMEDIES, 49 



PART III. 

PHARMACOLOGICAL REMEDIES. 

Pharmacological Remedies, or Medicines, are substances not 
essentially alimentary, which, when applied to the body, so alter or 
modify its vital functions as to be rendered applicable to the treatment 
of diseases. Pharmacology, accordingly, treats of the physiological 
action of drugs. For convenience of study the action of medicines is 
divided into local and internal : they are termed local when applied 
directly to a part (cauterants, for example) ; internal, when the 
economy is affected, as by way of the stomach, rectum, skin, or hypo- 
dermically. This division, however, is arbitrary, since the local appli- 
cation of many substances eventually exerts an influence on the 
system. The term succedaneum is applied to remedies possessing a 
similar action, which can be substituted for each other therapeutically. 

The designation Materia Medica is, strictly speaking, limited to the 
consideration of the nature and properties of the remedies used in 
medicine. Pharmacy is the department of Maceria Medica which 
treats of the collection, preparation, preservation, and dispensation of 
medicines. 

To the student of medicine, the objects of examination in relation 
to medicines are — the sources from which they are derived ; the mode 
in which they are prepared and brought to market; their sensible 
qualities, and also their chemical composition and relations; their 
physiological effects, or the effects which they are capable of pro- 
ducing in healthy individuals ; their therapeutical effects, or those which 
they produce in morbid states of the system ; and, lastly, the doses, 
modes of administration, and preparations (extemporaneous and offi- 
cial), under which they are administered. 

To facilitate a uniform nomenclature and dispensation of medi- 
cines, authoritative works have been issued in different countries, 
termed Pharmacopoeias. The Pharmacopoeia of the United States was 
first promulgated by the authority of a convention held at Washing- 
ton, in 1820, and it has since been revised decennially. It furnishes a 
list of articles which are in general use, including a description of the 
same, describes tests for their purity where required, sets forth the 
weights and measures which are employed in dispensing and prepar- 
4 



50 MATERIA MEDICA AND THERAPEUTICS. 

ing them, and supplies formulae for such preparations as should be 
kept in the shops, and which are hence termed official, from the Latin 
word officium, authority. "All the articles are arranged in a continu- 
ous alphabetical order," and in no instance is the dose given. A Dis- 
pensatory differs from the U. S. Pharmacopoeia in containing, besides 
other matters, the medical and physical history of the various sub- 
stances with directions for dispensing the same ; the Pharmacopoeia is 
mainly restricted to the mode of preparing them ; it is official, while 
the Dispensatory is not. 

The articles considered under Materia Medica proper, or phar- 
macological agents, may be conveniently classified for the purpose of 
study under three divisions, viz.: 

i. Inorganic. 

2. Animal. 

3. Organic. 

The inorganic embrace the metallic and non-metallic bodies of 
which the iron, lead, mercurial, iodic and various other salts and com- 
pounds constitute familiar examples. They do not call for particular 
notice here. 

From the animal kingdom are obtained a large number of dissimi- 
lar agents, as musk, pepsin, pancreatin, cantharides, cochineal, sperma- 
ceti, wax, isinglass, besides such fatty bodies as suet, lard, lanolin, and 
cod-oil, all of which are duly described in their respective chapters. 

The organic comprise the vegetable agents. In these are found 
various proximate principles upon the presence of one or more of 
which the activity of the plant depends. They are termed alkaloids, 
resins, oleoresins, gums, gum-resins, oils fixed and volatile, pectin, vege- 
table acids, glucosides, starcli, sugar, ferments, bitter- extractive and 
albuminous principles. 

The alkaloids, so called from their resemblance to the alkalies, are 
organic bases containing nitrogen. They are mostly solid and crystal- 
lizable, only a few being liquid and volatile without decomposition. 
They have an alkaline reaction, and neutralize acids with the formation 
of salts. The free alkaloids are, for the most part, very sparingly solu- 
ble in water, more readily soluble in alcohol, and many are also soluble 
in ether. The salts, on the other hand, are usually more freely soluble 
.in water, and are also soluble in alcohol, but either insoluble or spar- 



PHARMACOLOGICAL REMEDIES. 5L 

ingly soluble in ether. Most of the alkaloids, or their salts, are pre- 
cipitated from their solutions by tannic acid, mercuric chloride, the 
iodides, or bromides of the alkalies, and especially by compounds of 
the latter with the heavy metals, such as potassio-mercuric iodide 
potassio-bismuthic iodide, etc. 

The molecular structure of most of the alkaloids is not yet known ; 
but there is good evidence for the belief that they are derivations of 
one or more molecules of ammonia, NH 3 , in which the hydrogen atoms 
of the latter are replaced by other more complex radicals. 

The alkaloids usually represent, to a large extent, the active prin- 
ciple of the plant from which they are obtained, and many of them 
possess strongly toxic properties. 

The resins are non-volatile, brittle, solid bodies, found generally 
associated with the volatile oils in plant-life, and are thought to be 
mixtures of weak acids. By the oxidation of the volatile oil, or by dis- 
tilling it, the resin is obtained. Resins are freely soluble in alcohol, 
forming varnish. Oleoresins are mixtures of a resin and a volatile or 
fixed oil. Resins that yield cinnamic or benzoic acids are termed 
balsams. 

The gums are amorphous exudations from the stems of various 
plants, insoluble in alcohol, and which with water swell up to form 
mucilage. They are composed of two carbohydrates, arabin and basso- 
rin, which exist united as acids to magnesium, potassium, or calcium. 
Gum-resins are likewise plant-exudations and consist of gums, resins, 
and volatile oils in various proportions. 

The fixed oils, as castor, olive, etc., are chemical compounds of 
stearic, palmitic, and oleic acids, united to the base glyceryl. They 
are obtained by expression. In the process of saponification the base 
is liberated as glycerin, the acidulous radical forming with the alkali, 
soap. 

Volatile or essential oils are mostly obtained by subjecting the 
leaves, flowers, fruit, or other part of the plant, to distillation with 
steam, only a few, such as those of the citrous-fruits, being obtained by 
expression. They usually possess, in a high degree of concentration, 
the characteristic odor of the plant from which they are derived. They 
are generally of complex composition, and differ widely from each 
other with respect to the chemical character of their constituents. 
Most of them contain one or more hydrocarbons, known as terpenes, 
C 10 H 16 , of which the oil of turpentine, for example, is chiefly composed, 
while others may contain aldehydes, ketones, phenols, alcohols, or 



52 MATERIA MEDICA AND THERAPEUTICS. 

compounds of the latter, with organic acids, which are known as com- 
pound ethers. Some of the constituents of volatile oils are solid at 
ordinary temperatures, and such bodies are commonly known as stearop- 
tens. The latter may vary widely in their chemical character, being 
either a phenol, such as thymol ; an alcohol, such as menthol ; a mix- 
ture of hydrocarbons, such as the stearopten of oil of rose ; or, an 
organic acid, such as the chief constituent of oil of orris. 

Most of the volatile oils become more or less oxidized by expo- 
sure to the air and light, with the formation of resinous bodies or other 
products of decomposition. 

Pectin is a peculiar body which imparts to plant-juices the property 
of gelatinization. It forms a large portion of Irish moss. 

The usual vegetable acids are citric, tartaric, acetic and tannic, 
though many others are obtained from the vegetable Materia Medica. 
Citric and tartaric exist naturally in the juices of the fruits of various 
plants. Acetic, though found in minute proportion in nature, is an 
artificial product obtained by the destructive distillation of wood, or by 
the oxidation of ethylic alcohol in the presence of a nitrogenous fer- 
ment. Tannic acid, the astringent principle of galls, oak-bark, etc.. is 
widely diffused throughout the vegetable kingdom, and is obtained from 
galls by the agency of washed ether. The vegetable acids unite to form 
definite compounds with various bases. Tannic acid, though a gluco- 
side, precipitates those bodies as well as the alkaloids, and forms with 
ferric salts, ink. 

The glycosides are vegetable substances composed of carbon, 
hydrogen and oxygen, which may be resolved by the aid of ebullition, 
acids, alkalies or ferments into sugar by taking up the elements of 
water; at the same time a second body is formed which differs accord- 
ing to the substance acted on. Salicin and tannin are familiar examples 
of glucosides. Such neutral principles as elaterin and picrotoxin are 
classed with the glucosides, though of uncertain nature. 

The remaining vegetable proximate principles do not call for 
special mention here. The ferments y emnlsin and amygdalin are noticed 
under oil of almonds and mustard ; sugar and starch with demulcents ; 
bitter- extractive with tonics. 

MODUS OPERANDI OF MEDICINES. 

The medium through which the influence of medicines is exerted 
on remote parts of the body, or their modus operandi (as it is usually 
termed), was long a contested point ; but it is now generally admitted 



PHARMACOLOGICAL REMEDIES. 53 

that the absorption or passage of the medicinal or poisonous molecules 
into the blood is necessary to their action on parts remote from the seat 
of impression. It was Magendie who first conclusively demonstrated 
that poisons act on the spinal cord through the circulation, and not by 
means of the lymph and nerves. 

While, however, it is well established that the characteristic action 
of medicines is transmitted to the parts influenced exclusively through 
the medium of the circulation, it is undeniable that the functions of the 
nervous system may be secondarily excited by a local medicinal im- 
pression. The number of agents which operate in this manner is, how- 
ever, very limited. 

The action of medicines by absorption is proved by a variety of 
facts. 

They are detected in many parts of the system remote from that 
to which they have been applied, having been found in the blood, the 
solids, and the excretions, after being taken into the stomach. If the 
circulation be interrupted, the influence of a poison cannot be trans- 
mitted; while its effects have been obtained, when applied to a wound 
in the foot of an animal, after all parts of the extremity have been 
severed except the artery and vein. In confirmation of the doctrine of 
absorption may be cited also the admitted facts, that the remote effects 
of medicines or poisons are promoted or retarded by circumstances 
which promote or retard absorption ; that the blood of poisoned animals 
is found to possess poisonous properties ; that the fluids and solids ac- 
quire medicinal properties after the use of medicines (as the milk of 
nurses) ; that the specific effects of medicines are produced by their 
injection into the blood; and that medicines disappear from closed 
cavities into which they are introduced. 

After their absorption into the blood, medicines circulate with it, 
penetrate through the capillaries to the various organs, and are after- 
ward thrown out of the system with the excretions. Some medicines 
produce changes in the condition of the circulating fluid. Others have 
a specific action upon some one or other of the organs of the body. 
And, in passing out of the system, most medicines act as excitants of 
the organs by which they are thrown out. 

The absorption of medicines is effected principally by the capil- 
laries, and in some degree also by the lymphatics and lacteals. The 
medicinal particles penetrate or soak through the interstices of the tissue 
with which they are placed in contact, and are thence diffused through 
the circulation. To a limited extent, medicinal substances probably 



•34 MATERIA MEDICA AND THERAPEUTICS. 

penetrate all the tissues of the part to which they are applied, and in 
this way the activity of medicines is most decided upon the organs 
contiguous to the seat of application. 

The absorption of insoluble substances cannot take place until 
they are previously rendered soluble. In the stomach this is accom- 
plished partly by the agency of the acids of digestion and partly by the 
albuminoid constituents of the gastric fluid. Some substances are dis- 
solved by the alkaline liquids of the small intestine. 

It is objected to the theory of the operation of medicines by ab- 
sorption, that certain poisons act with a rapidity incompatible with their 
previous introduction into the circulation. This is, however, not the 
fact, as the action of the most violent poisons (hydrocyanic acid, for 
example) is never wholly instantaneous ; and careful experiments have 
shown that the velocity of the circulation is sufficient to diffuse a poison 
through the blood in a shorter space of time than its effects are ever 
observed on the system. 

GENERAL CIRCUMSTANCES WHICH MODIFY THE EFFECTS OF MEDICINES. 

The circumstances which modify the effects of medicines relate 
both to the medicines and to the human system. 

1. The properties of medicines are modified by the soil in which 
they grow, by climate, cultivation, age, and the season of the year at 
which they are gathered. 

2. Medicines are more active, because more readily absorbed, in a 
state of solution than in a solid state. 

3. Medicines may be often rendered inert by one of three things, 
viz: (1) Insolubility, (2) Chemical Decomposition, or (3) Physiologi- 
cal Antagonism. When such action takes place they are said to be 
incompatible. 

(1) Solubility. — The two commonest solvents are water and alco- 
hol or their mixtures. Water dissolves all soluble salts, albumen, 
gums, sugars, acids, gelatin; and alcohol, resins, gum-resins, balsams, 
most oils, iodine, camphor, etc. If to any alcoholic medicinal solution 
containing the last-named substances, water in the form of infusions, de- 
coctions, etc., be added, a separation of the substance dissolved takes place 
and vice versa as regards aqueous and alcoholic solutions, and thus are 
formed unsightly and disagreeable mixtures. Examples are the addi- 
tion of enough water to spirits of camphor and paregoric, which throws 
out the camphor from solution. Such mixtures, however, though phar- 
maceutically incompatible, are yet therapeutically active. It must be 



PHARMACOLOGICAL REMEDIES. 55 

borne in mind, also, that the solvent power of each of these solvents 
diminishes proportionately for its class of substances with the quantity 
of the other one added. Tinctures and fluid extracts containing resin, if 
prescribed with water, should first be emulsified, and the oils and the 
oleoresins likewise require emulsification. Any mixture likely to re- 
main turbid should have a " shake-label " attached. 

(2) Chemical Decomposition. — Under this heading are included (#)the 
combination of free acids with carbonates or hydrates, or the reverse ; [6) 
the association of soluble salts, a change of base or acid taking place, giv- 
ing rise to the formation of new compounds with different properties and 
action ; and (c) the bringing together of agents which may give rise to 
explosive processes. Acids decompose the carbonates, hydrates and 
metallic salts, forming new compounds. The alkalies neutralize the 
acids, and vice versa, and their hydrates precipitate all the alkaloids and 
decompose many of the glucosides. A double decomposition takes 
place when zinc acetate and lead sulphate are brought together in solu- 
tion, lead sulphate insoluble and inert being precipitated, the acetic 
radicle uniting with the zinc. Chemical incompatibility* might be end- 
lessly multiplied, but the following rules are sufficiently comprehensive 
and should be borne in mind : — Acids and alkaloids should not be pre- 
scribed with the alkalies or their carbonates ; salts of the alkaline earths, 
viz., barium, calcium, strontium, and magnesium should never be mixed 
with the soluble tartrates and carbonates. The alkalies and their car- 
bonates should never be prescribed with the salts of the heavy metals, 
as zinc, silver, iron, lead, mercury, etc. The argentic salts cannot be 
prescribed with the chlorides, iodides, hydrochloric acid or organic 
matter. The soluble plumbic salts must not be mixed with hydro- 
chloric, hydriodic or sulphuric acids or the chlorides. The bromides 
precipitate morphine and strychnine, and the iodides yield deposits 
with the alkaloids. Sodic biborate precipitates morphine and cocaine. 
When oxidizing agents like potassium permanganate and chromic acid, 
etc., are mixed with easily oxidized substances as sulphur, the carbohy- 
drates, etc., explosive compounds are formed. 

(3) Physiological Antagonism. — Medicines are often rendered inert 
by a physiological antagonism exerted by some other medicament taken 
at or about the same time ; for instance, atropia and pilocarpia act in 
an opposite way upon the skin ; homatropine and eserine on the iris. 

4. Differences in dose greatly modify the effects of medicines. 

* On Incompatibility see ""Prescription Writing," Mann; Am. Jour, of Pharm., Jan., 
1890, J. W. England; and Med. Record, April, 14, 1894, Dr. J. Kennedy. 



56 MATERIA MEDICA AND THERAPEUTICS. 

5. Pharmaceutical modifications have an important influence on 
the efficacy of medicines. They may be exhibited in the solid, semi- 
solid, liquid and aeriform states. 

In the solid state they are administered in the shape of tritura- 
tions, powders, pills, lozenges, confections and papers. 

In the liquid state they are administered in the shape of mixtures, 
solutions, medicated waters, infusions, decoctions, tinctures, spirits, 
wines, vinegars, honeys, syrups, fluid extracts, glycerites and oleo- 
resins. 

In the semi-solid or soft state they are employed internally, in the 
form of suppositories and extracts ; and externally in that of liniments, 
ointments, cerates, oleates, plasters and cataplasms. 

In the form of gases and vapors, medicines are used for purposes 
of inhalation. 

SOLIDS. 

Triturations (Triturationes) are prepared by thoroughly triturating 
in a mortar, 10 parts of the medicinal substance with 90 parts of sugar 
of milk which should be gradually added, and the process continued 
until the whole is thoroughly mixed and finely powdered. Tablet tritu- 
rates are minute disk-like masses of medicinal powders, the basis of 
which is usually sugar. The powder is held together and the tablet 
retains its shape through the adhesion of the particles developed by the 
use of a volatile liquid. The tablet is completed by pressing the paste 
into perforations of metal, glass, etc. 

Powders {Pulveres). — The form of powder is usually selected for 
the administration of medicines which are not bulky, nor of disagreeable 
taste, have no corrosive property, nor deliquesce rapidly on exposure. 
Deliquescent substances, and such as contain a large proportion of fixed 
or volatile oil, should always be recently pulverized, as they deteriorate 
v/hen kept. Most substances employed in the form of powder are 
usually pulverized on a large scale. For the purpose of pulverizing 
drugs in small quantities, the physician makes use of a pestle and mortar, 
the finer particles being afterward separated from the coarser by a sieve. 
In some cases, a stone-slab and muller are used. Some powders are 
obtained by precipitation ; and the finer particles of a powder are often 
separated from the coarser by a process termed elufriation, in which the 
powder is diffused through water, the heavier portions being first al- 
lowed to subside, and the liquid being poured off, the finer particles 
settle separately. Volatile substances are often finely powdered by 
and by suddenly condensing their vapors. 



PHARMACOLOGICAL REMEDIES. 57 

Salts of difficult pulverization are often granulated by making a 
hot, saturated solution of the salt, and filtering and stirring the filtered 
liquid until cool. Of late years granulated effervescing salts have been 
used in imitation of the waters of mineral springs, the effervescence 
being produced by the addition of sodium bicarbonate and tartaric or 
citric acid. 

Pills [Pilulce) are small globular masses, of a semi-solid consist- 
ence, and of a size that can be conveniently swallowed. 

The form of pill is suitable for the exhibition of medicines which 
are not bulky, and are of disagreeable taste or smell, or insoluble in 
water. Deliquescent substances should not be made into pills, and 
those which are efflorescent should previously be deprived of their 
water of crystallization. 

Some substances are readily made into pills with the addition of a 
little water, spirit, glycerin, extract of gentian, or syrup. Very soft or 
liquid substances require the addition of some dry inert powder, as 
acacia, to reduce them to a proper consistence. Wax is a good 
excipient for oils. 

Heavy powders are mixed with some soft solid, as confection of 
rose, plasma, manna, etc., or with a tenacious liquid, as syrup. When 
the pilular mass is properly prepared, it is rolled with a spatula into a 
cylinder of uniform thickness, and is then divided into the required 
number of pills, with the spatula, or, more accurately, with a pill-tile, 
or with a pill-machine. The pills are rolled into spherical form be- 
tween the fingers ; and, to prevent adhesion, are dusted with some dry 
powder, as powdered liquorice-root, lycopodium, orris-root, starch, or 
magnesium carbonate. They should weigh from one to four grains, 
unless metallic, when a weight of from six to eight grains is admissible. 
A large pill is termed a bolus. When long kept, pills become hard 
and dry, and may pass unchanged through the stomach and bowels, 
and are, therefore, objectionable. To conceal the taste and smell of 
pills, they are sometimes coated with gelatin, collodion, mucilage, 
sugar, etc. When they are designed to be of slow operation, the 
modern practice of sugar coating pills answers very well. But, when 
they are intended to act quickly, the coating is objectionable, as it 
retards the solution of the pills in the gastric fluid. Compressed pills 
are made without excipients, simply by subjecting medicinal sub- 
stances to pressure in moulds ; in this way extraneous matter is 
avoided, and smaller bulk is secured. Gelatin-cap sides are used to 
enclose disagreeable medicaments. 



5S MATERIA MEDICA AND THERAPEUTICS. 

Troches or Lozenges [Trochisci) are small, dry, solid masses made 
of powders with sugar and mucilage, and intended to be held in the 
mouth and allowed to dissolve slowly. Mucilage of tragacanth is 
usually employed in preparing lozenges. 

Coufectious (Coufectiones) are soft, solid preparations, made with 
some saccharine matter. 

Papers {Charted) are preparations designed for external applica- 
tion, which are made by spreading mixtures of medicinal substances, 
as cantharides or mustard, upon paper. 

LIQUIDS. 

Mixtures (Misturcz) are preparations of insoluble substances sus- 
pended in water by means of acacia, sugar, the yolk of eggs, or other 
viscid matter. When the suspended substance is oleaginous, the 
mixture is termed an emulsion. 

Solutions [Liquor es) are solutions (chiefly aqueous) of non-volatile 
substances, which are wholly soluble in the menstruum employed. 
In making solutions, and all other aqueous preparations, the water 
used should be fresh river, rain, or distilled water, and free from saline 
impurities. 

Medicated "Waters {Agues) are preparations consisting of water 
holding volatile or gaseous substances in solution. They are best 
made by distilling water from plants containing volatile oils, and are 
hence termed distilled waters. In place of distillation trituration with 
magnesium carbonate (afterwards separated by filtration) is often em- 
ployed to impregnate water with volatile oils; but the watery distillates 
have a more delicate fragrance and flavor. 

Infusions (Infusa)* are partial solutions of vegetable substances 
in water, obtained without the aid of ebullition. They are made with 

* " An ordinary Infusion, the strength of which is not directed by the physician, nor 
specified by the Pharmacopoeia, shall be prepared by the following formula : — 

Take of 

The Substance, coarsely comminuted, jifty grammes 50 Gm. 

Boiling Water, one thousand cubic centimeters iooo Cc. 

Water, a sufficient quantity 

To make one thousand cubic centi??ieters . . 1000 Cc. 

Put the Substance into a suitable vessel, provided with a cover, pour upon it the Boiling 
Water, cover the vessel tightly, and let it stand two hours. Then strain, and pass enough 
Water through the strainer to make the infusion weigh one thousand (1000) Cc" — (U. S. 
P., 1890.) 



PHARMACOLOGICAL REMEDIES. 59 

both hot and cold water ; the former extracts the soluble principles 
more rapidly and in larger proportion ; the latter is preferred, should 
the active principles be injurable by heat, or if it be desirable not to 
take up some matter insoluble at a low temperature. When the pro- 
cess takes place at a heat of from 6o° to 90 , it is termed maceration ; 
when at a heat of from 90 to ioo°, digestion. A more efficient mode 
of extracting the medicinal virtues of plants is percolation or displace- 
ment. In this operation the medicinal substance is coarsely powdered 
and placed in a conical or nearly cylindrical instrument called a per- 
colator, in the lower part of which is fitted a porous or colander-like 
partition or diaphragm. The powder is then saturated with water or 
other menstruum till it will absorb no more ; and after they have 
remained for some time in contact, fresh portions of the menstruum 
are added, till the required quantity is employed. The fresh liquid, 
as it is successively added, percolates the solid particles of the medi- 
cinal substance, driving the previously saturated liquid before it ; and 
in this way completely exhausts the substance to be dissolved. An 
ordinary glass-funnel answers very well for percolation ; and a circular 
piece of muslin or lint, pressed into the neck by means of a cork with 
notched sides, forms a good diaphragm — care being taken to interpose 
a similar piece of muslin, moistened slighty with the menstruum be- 
tween the diaphragm and powder. 

Decoctions (Decoctd)* are partial solutions of vegetable substances 
in water, in which the active principles are obtained by ebullition. 
This is a more rapid and efficient mode of extracting the virtues of 
plants than by infusion. But it is objectionable when the proximate 
principles are volatile at a boiling heat or undergo decomposition by 
ebullition. In making decoctions ebullition should be continued for a 
few minutes only, and the liquid should be allowed to cool slowly in a 



* " An ordinary Decoction, the strength of which is not directed by the physician, nor 
specified by the Pharmacopoeia, shall be prepared by the following formula : — 

Take of 

The Substance, coarsely comminuted, fifty grammes .... 50 Gm. 
Water, a sufficient quantity 

"~ * 
To make one thousand cubic centimeters . . . 1 000 Cc. 

Put the Substance into a suitable vessel, provided with a cover, pour upon it 1000 Cc. of 
Cold Water, cover it well, and boil for fifteen minutes, then let it cool to about 40 C. 
(104 F.). Strain the liquid, and pass through the strainer enough cold water to make the 
product measure 1000 Cc." — (U. S. P., 1890.) 



60 MATERIA MEDICA AND THERAPEUTICS. 

close vessel. As they are apt to spoil, they should be prepared only 
when wanted for use. 

Tinctures (Tincture?) are solutions of medicinal substances in 
alcohol or diluted alcohol. The aromatic spirit of ammonia and 
ethereal spirit are also sometimes employed as solvents; and solutions 
in these menstrua are called ammoniated tinctures and ethereal tinc- 
tures. Alcohol or rectified spirits (sp. gr., 0.820, U. S. P.) is employed 
in making tinctures of substances nearly or quite insoluble in water, as 
the resins, iodine, etc. Diluted alcohol or proof-spirit (equal weights 
of official alcohol and water) is preferred when the substance is soluble 
both in alcohol and water, or when some of its ingredients are soluble 
in the one menstruum and some in the other. Tinctures have been 
usually prepared by maceration or digestion, more commonly by the 
former process, and a period of two weeks is recommended for its 
duration. It should be conducted in well-closed glass-vessels, which 
should be frequently shaken, and when the maceration is completed, 
the tincture should be separated from the dregs by filtration. The 
U. S. P. now recommends percolation in making most tinctures, and 
in the hands of skillful pharmaceutists this process is preferable, as the 
most thorough mode of exhausting medicinal substances ; but, where 
the operator cannot trust himself, it is better to recur to the old pro- 
cess of maceration. Tinctures should be kept in bottles accurately 
stoppered to prevent evaporation, which might seriously increase their 
strength. They may be now had in the form of tablet triturates or 
compressed pills. 

Tinctures of Fresh Herbs (Tincture? Herb arum Recentiuin). — 
"These tinctures, when not otherwise directed, are to be prepared by 
the following formula : — 

Take of 

The Fresh Herb, bruised or crushed, five hundred grammes . . 500 Gm. 
Alcohol, one thousand cubic centimeters .;.,,.... 1 000 Cc. 

Macerate the herb with the alcohol for fourteen days ; then express 
the liquid and filter."— (U. S. P., 1890.) 

The form of tincture is adapted to the exhibition of medicines 
which are to be given in small quantity, and it affords a convenient 
mode of graduating doses. In prescribing large and continued doses 
of tinctures, the stimulating effects of the alcohol which they contain 
must be borne in mind. 

Spirits (Spiritus) are alcoholic solutions of volatile or gaseous 



PHARMACOLOGICAL REMEDIES. 61 

principles, procured* by (i) distillation, (2) solution, (3) solution with 
maceration, (4) gaseous solution, and (5) chemical action. The spirits 
of the aromatic vegetable oils are used to give a pleasant odor and 
taste to mixtures, to correct the nauseating and griping effects of 
cathartics, and also as carminatives and stomachics. 

Wines (Vina) are solutions of medicinal substances in stronger 
white wines. They are more permanent than decoctions and infusions, 
owing to the presence of alcohol. 

Vinegars (Acetd) are infusions or solutions of medicinal substances 
in diluted acetic acid. 

Honeys (Mellitd) are preparations of medicinal substances in 
honey. 

Syrups (Syrupi) are preparations of medicinal substances in con- 
centrated solutions of sugar. The term syrup {syrupus), or simple 
syrup, is applied to a solution of sugar (85 parts) in water (sufficient 
to make 1000 parts of syrup), dissolved with the aid of heat. Medi- 
cated syrups are usually made by incorporating refined sugar with 
vegetable infusions, decoctions, expressed juices, fermented liquors, or 
simple aqueous solutions. They may also be prepared by adding a 
tincture to simple syrup, and afterward evaporating the alcohol ; or by 
mixing the tincture with sugar in coarse powder, and dissolving the 
impregnated sugar, after evaporation, in the necessary proportion of 
water. Syrups are apt to be spoiled by heat, and should be made in 
small quantities at a time. 

Fluid Extracts (Extracta Fluidd) have the advantage over solid 
extracts of convenience of administration, and of being prepared at a 
less degree of heat. In preparing them alcohol and glycerin are the 
menstrua chiefly resorted to. They are obtained* by: (1) percolation 
with partial evaporation, (2) percolation with incomplete exhaustion, 
(3) re-percolation, (4) maceration with pressure, and (5) vacuum macer- 
ation with percolation. Fluid extracts may now be had in the form 
of tablet triturates or compressed pills. According to the U. S. P., 
1890, 1 c.c. of the fluid extract represents 1 gm. of the drug. 

Glycerites (Glyceritd) are mixtures of medicinal substances in 
glycerin, made by rubbing them together in a mortar. 

Oleoresins (Oleoresince) are extracts obtained by the agency of 
ether by percolation, which consist of fixed or volatile oils, holding 
resins, and sometimes other active matters in solution. They retain a 

* Remington's Pharmacy. 



68 MATERIA MEDIC A AND THERAPEUTICS. 

liquid or semi-liquid state upon the evaporation of the menstruum em- 
ployed in their preparation, and have the property of self-preservation. 

SEMI-SOLIDS. 

Suppositories [Suppositoria) are soft solids, made by the mixture 
of a medicinal substance with the oil of theobroma, usually in a conical 
form, of the weight of 15 grains, and designed for introduction into the 
rectum. They are, however, often used weighing gr. 30. They are 
employed with a view both to a local effect on the lower bowel and 
also to the gradual absorption of the medicinal substance. As absorp- 
tion from the rectum is slow, larger quantities are required than by the 
mouth. The vaginal suppository should be globular and of the weight 
of one drachm, at least. Aural, nasal and urethral suppositories are 
also used. 

Extracts (Extracta). — By the evaporation of the solutions of veg- 
etable principles, a very useful class of preparations, termed Ex- 
tracts, is obtained. They are prepared from infusions, decoctions, 
tinctures and vinegars, and sometimes, in the case of recent vegeta- 
bles, from the expressed juices of plants, usually diluted with water. 
Extracts prepared by the agency of water are termed watery extracts ; 
those by means of alcohol, alcoholic extracts ; those by means of acetic 
acid, acetic extracts. The evaporation of extracts is generally con- 
tinued till they have a pilular consistence. 

Liniments (Linimenta) are solutions, mixtures, alcoholic liquids, 
or oily preparations designed for external use, usually thicker than 
water, but always liquid at the temperature of the body. 

Ointments [Unguenta) are preparations of a consistence like that 
of butter, made with lard or some other fatty substance. They are 
fitted for application to the skin by friction or inunction. Most of the 
ointments become rancid when long kept, and it is therefore best to 
prepare them only as wanted for use. They are made by chemical 
reaction, fusion, and incorporation. The term ointment {iingnentuni) 
is applied to a mixture of 20 parts of yellow wax and 80 parts of lard. 
Petrolatum, a substitute for vaseline, a straw-colored ointment made 
from petroleum, not decomposable, is a superior unguent for general 
purposes (see petrolatum). 

Cerates (Ceratd) are made of oil, petrolatum, or lard as a basis, 
mixed with enough wax to give the necessary consistency. Sperma- 
ceti or resin is used to raise the melting point of fats. They are of 
harder consistence than ointments, and do not melt when applied to 



PHARMACOLOGICAL REMEDIES, 63 

the skin. The term cerate (ceratum) is applied to a mixture of 30 
parts of white wax and 70 parts of lard. 

Oleates (Oleatd) are made by combining oleic acid with metallic 
bases or alkaloids, and are solutions of these in excess of oleic acid. 
The combination is effected by rubbing them together in a mortar, and 
is generally aided by heat. 

Plasters (Emplastrd) are adhesive at the temperature of the body, 
and must generally be heated to be spread. Some substances have 
sufficient consistence and adhesiveness to be made into plasters. 
Usually, however, medicinal substances, when employed in this form, 
are mixed either with Lead Plaster [Emplastrum Plumbi), or a gum- 
resin, or Burgundy pitch. Plasters are prepared for use by spread- 
ing them upon sheepskin, linen or muslin, with a margin a quarter or 
half-inch broad. 

Cataplasms or Poultices (Cataplasmatd) are soft, moist substances 
intended for external use. The common emollient poultice, employed 
to relieve inflammation and to promote suppuration, is made by 
mixing bread-crumbs with boiling milk or powdered linseed with 
boiling water {see poultices). 

GASES AND VAPORS. 

When employed in this form medicines are administered by inhala- 
tion (see p. 76). This may be effected either by diffusing the gas or 
vapor through the air to be respired by the patient ; or by inclosing it in 
a bag or bottle with a suitable tube, through which the patient may 
breathe; or, when ethereal vapors are employed, by saturating a 
sponge or handkerchief with the ether and applying it to the mouth 
and nostrils of the patient; or the fumes of burning medicinal sub- 
stances may be inhaled by means of cigarettes or pipes variously con- 
trived. 

WEIGHTS AND MEASURES. 

In prescribing and dispensing medicines the following are the 
weights and measures employed in the United States, with their signs 
annexed : — 

TROY OR APOTHECARIES' WEIGHT. 



The pound, ft) 
The ounce 
The drachm 
The scruple 



Twelve ounces, J. 

Eight drachms, 3 . 

Three scruples, 9* 

Twenty grains, gr. 



The term pound should be avoided in formulae, owing to the 



04 MATERIA MEDICA AND THERAPEUTICS. 

danger of mistakes from confounding the Troy pound with the 
heavier avoirdupois pound, and large weights should be expressed in 
Troy ounces. The scruple sign (3) should not be used in prescribing, 
because of the liability of mistaking it for the drachm (5). All 
weights of less than a drachm should be expressed in grains (gr.). The 
Troy ounce contains 480 grains ; the drachm, 60 grains. 

In France and other parts of the continent of Europe a system of 
metrical weights is employed, having for its unit the meter (39.37 
inches), which is the ten-millionth part of the distance from the pole 
to the equator measured on any meridian. From this basis all other 
weights and measures are calculated. As all the divisions are ob- 
tained from the multiple ten, it is purely a decimal system. The 
names given to the different multiples and divisions of the unit are in- 
dicated by prefixes derived from the Latin and Greek. 

FOR SUBDIVISION. 

f Milli indicates the T ^ si j of the unit. 
Latin -| Centi " " T ^ " " 

[ Deci " " T \ " 

FOR MULTIPLICATION. 

Deca indicates 10 times the unit. 

Hecto " 100 " " 

Kilo " 1000 " 

Myria " ioooo " " 



Greek - 



In the metric system, fluids as well as solids are expressed by 
weight, consequently the gram (unit of weight) and its decimal divi- 
sions enter only into the calculation of a prescription. A gram 
is the weight of a cubic centimeter of water at 4 C. The sub- 
divisions of the gram are milligram, centigram and decigram ; the 
multiplications, decagram, hectogram, etc. Instead of using the 
latter terms the total is. better expressed in grams. The sign Gm. is 
used to denote gram ; c. c, cubic centimeter, and to denote quantity, 
Arabic figures ; the latter should precede the symbol. In prescribing 
liquids, allowance must be made for the relation existing between sp. 
gr. and bulk. In each case, of spirits, tinctures and oils T V less, of 
stronger ether 1 less, of spirit of nitrous ether $ less, of glycerin 
1 more, of syrup 1 more, of chloroform \ more, must be ordered. In 
the case of spirits and tinctures the difference being so slight it may be 
discarded. Rules for expressing quantity by weight of the Troy sys- 
tem in metric terms : A. Reduce the quantity to grains and divide 



PHARMACOLOGICAL REMEDIES. 



65 



by 15; the quotient expresses the quantity in grams (nearly). B. 
Reduce each quantity to drachms and multiply the number by 4 ; 
the product is the number of grams representing nearly the same 
quantity. These rules are to be employed in changing fluid measures 
to grams, substituting minims for grains if necessary. In round 
numbers 1 f o = 30 c. c. ; 1 c. c. or Gm. = gr. 15^ of distilled water 
at 4 C. It has been suggested to use the term flui-gram for c. c. 
(Mann and Oldberg.) 



Comparative Table of Decimal with Troy Weights. 



Names. 


Equivalent in Grams. 


Equivalent in Grains. 


Equivalent in Troy Weight. 








lb I 


Z g*- 


Milligram . . . 


.OOI 


.OI54 




1 


Centigram . 




.OI 


.1543 




i 


Decigram . 




.1 


1-5434 




1.5 


Gram . . . 




I 


I5-4340 




15.4 


Decagram . 




IO 


154.3402 




2 34.0 


Hectogram . 




IOO 


1543.4023 


3 


1 43.0 


Kilogram . 




IOOO 


15434.0234 


2 8 


1 14. 


Myriagrarn . . . 


I OOOO 


154340.2344 


26 9 


4 20. 



The gallon, C. 
The pint 
The fluidounce 
The fluidrachm j 



WINE OR APOTHECARIES' MEASURE. 

r 



contains 



Eight pints, O. 
Sixteen fluidounces, f ^ 
Eight fluidrachms, f 3 . 
Sixty minims, til. 



The " term gallon is not used by the U. S. Pharmacopoeia, that 
measure always being expressed in pints. 

Liquid measures are sometimes prescribed by drops, which, how- 
ever, vary in quantity according to the nature of the liquid, the shape 
and size of the vessel from which they are dropped, and even the 
amount of liquid which the vessel contains. Thus, a fluidrachm of 
distilled water contains 45 drops, while thjs measure of alcohol and of 
most tinctures contains 120 drops, and of chloroform 220 drops, or 
even more. Approximate measurements are also frequently employed 
in prescribing the less powerful liquids : thus a teacup is used for 
fSiv, or a gill ; a wineglass for fgij ; a tablespoon for f§ss ; a teaspoon 
for f5j ; but as these are uncertain, a graduated measure is preferable. 



66 



MATERIA MEDICA AND THERAPEUTICS. 



Maisch's Table for Converting Apothecaries' Weights and Measures into 

Grain Weights. 









Grams for Liquids. 


Troy Weight. 


Grams. 


Apothecaries' 

Measures. 












1 








Lighter 


Spec. Grav. 


Heavier 






| 


than Water. 


of Water. 


than Water. 


Grain T \ 


.004 


Minim 1 


.055 


.06 


.08 


1 
1? 


.005 


2 


.IO 


.12 


•15 


t 


.006 


3 


.16 


.18 


.24 


.008 


4 


.22 


.24 


.32 


* 


.OIO 


5 


.28 


•3 


.40 


I 


.016 


6 


.32 


.36 


.48 


i 


.02 


7 


.38 


• 42 


•55 


$ 


.03 


8 


•45 


•5 


.65 


1 


.05 


9 


•50 


•55 


■73 


I 


.07 


10 


\ -55 


.6 


.80 


2 


•13 


12 


.65 


.72 


.96 


3 


.20 


14 


.76 


.85 


1. 12 


4 


.26 


15 


.80 


•9 


1.20 


5 


.32 


16 


.90 


1.0 


1.32 


6 


•39 


20 


1. 12 


1.25 


1.60 


7 


•45 


25 


1.40 


1-55 


2.00 


8 


•52 


30 


1.70 


1.90 


2.50 ! 


9 


• 59 


35 


2.00 


2.20 


2.90 


io(9ss) 


.65 


40 


2.25 


2.50 


3-3° 


12 


.78 


48 


2.70 


3.0 


4.00 


14 


.90 


5o 


2.80 


3.12 


4.15 


15 


1. 00 


60 (f^j) 


3- 4o 


3-75 


5.00 


16 


1.05 


65 


3.60 


4.0 


5-30 


18 


1. 18 


72 


4.05 


4-5 


6.00 


20 OJ) 


1-3 


80 


4-5° 


5.o 


6.65 


24 


i-5 


9°( f 5iss) 


5.10 


5-6 


7.50 


3 o(5ss) 


1-95 


96 


5.40 


6.0 


8.00 


32 


2.1 


100 


5.6o 


6.25 


8.30 j 


36 


2.2 


I20(fgij) 


6.75 


7-5 


10.00 


*4oOij) 


2.6 


150(1 3 iiss) 


8.50 


9-5 


12.50 


45 


3-o 


• 160 


9.00 


10.0 


13-3° 


50 Ouss) 
60 (3J) 


3-2 


180 (fgiij) 


IO.IO 


11.25 


15.00 | 


3-9 


210 (fspiiss) 


11.80 


13.0 


I7.50 


70 


4-55 


2 4 o(f 3 iv) 


13.50 


15.0 


20.00 


8oOiv) 


5-2 


13 V 


16.90 


18.75 


25.00 


90 (^iss) 


5-9 


fgvss 


18.60 


20.75 


27.50 


100 (9v) 


6.5 


f^vj 


20.25 


22.5 


30.00 


iio(9vss) 


7-1 


fgvij 


23.60 


26.25 


35- 00 


120 (3ij) 


7.80 


f^viij (f^j) 


27.00 


30.0 


40.00 


150 ( ^iiss) 


9-75 


f^ix 


30.40 


33-75 


45.00 


180 (ziij) 


11.65 


f^x 


33.75 


37-5 


50.00 


240 ( J ss) 


15.5 


fgxij (fjiss) 


40.50 


45-° 


60.00 


300 (. 3 v) 


19.4 


f ^xiv 


47-25 


52.5 


70.00 


36o (£vj) 


23.3 


f P 


54.oo 


60.0 


80.00 


420 ( g vij) 


27.2 


f 3 iiss 


67.50 


75-o 


100.00 


48o ( 5 i) 


3i. 1 


f I!!J 


81.00 


90.0 


120.00 


Sjj 


62.2 


f 5 iiiss 


94.5o 


105.0 


140.00 


,5 iv 


124.4 


fgiv 


108.00 


120.0 


160.00 



PHARMACOLOGICAL REMEDIES. 
Table for Converting Cubic Centimeters into Fluidrachms. 



67 



• 

Cubic Centimeters. 


0. 


1. 


2. 


3. 


4. 


5. 


6. 


7. 


8. 9. 




dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. 


dr. m. dr. m. 


O 


O 


O 16 


O 32 


O 49 


1 5 


I 21 


1 37 


1 53 


2 IO 


2 26 


IO 


2 42 


2 58 


3 15 


3 31 


3 47 


4 3 


4 19 


4 3 6 


4 52 


5 8 


20 


5 24 


5 4i 


5 57 


6 13 


6 29 


6 46 


7 2 


7 18 


7 34 


7 5i 


30 


8 7 


8 23 


8 39 


8 56 


9 12 


9 28 


9 44 


10 


10 17 


10 33 


40 


10 49 


" 5 


11 22 


II 38 


11 54 


12 10 


12 27 


12 43 


12 59 


13 15 


50 


13 3i 


13 48 


14 4 


14 20 


14 3 6 


H 53 


15 9 


15 25 


15 4i 


15 58 


60 


16 14 


16 30 


16 46 


17 2 


17 19 


17 35 


17 5i 


18 7 


18 24J18 40 


70 


18 56 


19 12 


19 28 


19 44 


20 1 


20 17 


20 34 


20 50 


21 6 I21 22 


80 


21 38 


21 55 


22 11 


22 27 


22 43 


23 


23 16 


23 32 


23 48124 4 


90 


24 20 


24 37 


24 53 


25 9 


25 26 


25 42 


25 58 


26 14 


26 31I26 47 



100 cubic centimeters are equal to 27 fluidrachms 3 minims, or 3 fluidounces 3 fluidrachms 
and 3 minims. 

PRESCRIPTION WRITING. 

The word prescription is derived from the Latin prce, before, and 
scriptum, written, and may be denned as the formula or directions for 
an apothecary which the physician writes for compounding and dis- 
pensing medicine, including directions regarding its use. Formulae 
may be either official (those published in any pharmacopoeia) or 
extemporaneous. Official formulae, the employment of which obviates 
all doubt as to what is meant, are in constant demand, particularly 
those representing drugs of well-tried efficacy and suitable combina- 
tion, and are ordered in place of those of the physician's composition. 
Prescriptions are either simple or compound : simple, if containing 
one ingredient ; compound, if two or more. Latin is employed in 
writing all parts of a prescription, except directions to the patient, 
first, because it is not subject to variations ; secondly, because often 
desirable to keep the patient in ignorance, and thirdly, because the 
Latin name of a drug is applied only to one substance. For example, 
if Yellow Root be ordered in English, the druggist will be in doubt 
whether or not to dispense Xanthorrhiza or Hydrastis ; but this 
would not occur if the Latin name were employed. 

Extemporaneous prescriptions are those composed by the physi- 
cian, and their structure may be considered under five divisions, viz. : 
I. The heading. 2. The names and quantities of the ingredients. 
3. Directions to the druggist. 4. The directions to the patient. 5. 
The date and signature. All these must be written legibly, so that 
there may be no doubt as to the meaning of any word or symbol. 
I. The heading. The prescription is begun with the symbol 1^ 



68 MATERIA MEDICA AND THERAPEUTICS. 

which stands for recipe, the imperative mood of the Latin verb recipio, 
meaning " take ° (thou). The straight line across the quirk of the R 
is a corruption or alteration of the Zodiacal sign " % " of Jupiter, to 
whom in ancient times it was customary by physicians to begin their 
prescriptions with pious invocations and blessings for their medicines. 
2. The names and quantities of the ingredients. These consist of (a) 
the basis or essential ingredient ; (U) the adjuvant or that which aids 
or promotes the action of the basis ; (c) the corrective or modifier of 
the action of the basis or adjuvant ; (d) the vehicle or excipient. In 
writing a prescription the sequence here given is the order usually 
observed, and each drug should be placed on a separate line. It is 
not necessary that a prescription should contain many ingredients, nor 
need it be limited to the divisions here described, and lastly, the basis 
may require neither corrective nor adjuvant. As to the quantity of 
each ingredient required, the following rule may be observed. After 
writing down the name of the medicine on a separate line, decide how 
much of it is to be contained in each pill, suppository, etc., or how 
many doses the mixture is to contain, and then the total number of 
doses multiplied by the quantity proper for the dose of each ingredient 
will give the total amount of that ingredient required (Mann), and 
this quantity is to be placed after the name of the drug. 3. 
Directions to the druggist. The method of compounding a prescription 
is usually left to the dispenser as he is supposed to understand 
pharmacy, unless the employment of some special procedure be 
desired by the physician. 4. The directions to the patient. This part 
is preceded by signa, and should be written in English and in full. The 
expression " as directed " ought to be avoided, as the patient may for- 
get the directions or not understand what is meant. If for " external 
use " it should be so stated on the label, and the medicine dispensed 
in a blue bottle. A poisonous label must be pasted on the bottle or 
box if the nature of the medicine demand it, and in the case of nar- 
cotics and intoxicants it is well to add " to be repeated " or " not to be 
repeated " as occasion may require. It is customary to write " wash " 
for " injection " in order not to arouse suspicion as to the malady ; and 
it is well to have written the name of the person who is to take the 
medicine on the label. 5. The date and signature. All prescriptions 
should be signed with the full name of the physician, his address and 
the date. Before parting with a prescription it should be carefully 
scrutinized to avoid error. 

Here are given the general rules for the construction of a pre- 



PHARMACOLOGICAL REMEDIES. 69 

scription, it being taken for granted that the student has some knowl- 
edge of Latin. Rule I. The noun expressing the name of the 
medicine is put in the genitive when the quantity to be used is 
expressed. 2. If no quantity is expressed, but only a numeral 
adjective follows, the noun is put in the accusative. 3. The quantity 
is put in the accusative case governed by recipe. (Rarely employed, 
the quantity being expressed by symbols.) 4. Adjectives agree with 
their nouns in gender, number and case. 

Rules for the formation of the genitive : Rule 1. Nouns ending in 
a form the genitive in 03, as quassia, quassise. Exceptions : physos- 
tigma, physostigmatis, aspidosperma, aspidospermatis ; folia is geni- 
tive plural foliorum. 2. Nouns ending in us, um, os and on form the 
genitive in i, as opium, opii, pyroxylon, pyroxyli. Exceptions : 
rhus, rhois, flos, floris, erigeron, erigerontis ; fructus, cornus, quercus, 
and spiritus remain unchanged ; aloe makes aloes and mastiche, mas- 
tiches. 3. All other nouns of whatever termination make the genitive 
in s or is as chloral, chloralis, alumen, aluminis, liquor, liquoris, fel, 
fellis. Some lengthen the termination, as acetas, acetatis, sulphas, 
sulphatis, pepo, peponis. Irregular forms of the genitive are asclepias 
asclepiadis, colocynthis, colocynthidis, hamamelis, hamamelidis, mas, 
maris, phosphis, sulphis and the like end in ids ; mucilago, mucilaginis, 
simplex, simplicis. The indeclinable nouns are amyl, buchu, cajuput, 
catechu, curare, jaborandi, kino, matico^ sassafras, sago, apiol, sumbul, 
chloralamid, iodol, adonidin, naphthol, salol, aristol, thymol, icthyol, 
exalgine, etc. 

Digitalis, hydrastis, berberis, and sinapis do not change in form- 
ing the genitive. To form the accusative : Rule 1. Nouns express- 
ing quantity ending in a are feminine and make the accusative singu- 
lar in am ; the plural in as ; drachma, accusative singular, drachmam ; 
accusative plural, drachmas. 2. Those # ending in um or us form the 
accusative singular in um. The accusative plural of those in us is in 
os, and of those in um in a. Nouns ending in us are masculine, in 
um neuter ; congius, accusative singular congium ; accusative plural, 
congios ; granum, accusative singular granam ; accusative plural, grana. 
All the adjectives are declined like the nouns, except unus, duo and 
tres ; the cardinals are indeclinable. The verbs are used mostly in 
the imperative mood in the sense of orders to the apothecary. The 
prepositions are few, those governing the accusative are ad, (to), in, (into) 
and ana, (of each) ; cum, (with) governs both the accusative and ablative. 

The translation of a prescription from English into Latin is here 
made in order to illustrate the rules previously given. 



70 MATERIA MEDICA AND THERAPEUTICS. 

Take of compound extract of colocynth, half a drachm ; 
Blue pill, twenty grains; 

Extract of opium, six grains ; 
Simple syrup, sufficient quantity. 
Mix and divide into twenty-four pills. 
In Latin this reads : 
Recipe extracti colocynthidis compositi, drachmae semissem ; (basis) 
Massae hydrargyri, scrupulum unum ; (adjuvant) 
Extracti opii, grana sex ; (corrigent) 
Syrupi simplicis, quantum sufficiat. (excipient) 
Misce et in pilulas viginti quatuor divide. 

Signa. — For -. Take one pill at bed-hour. 

Sydenham Laudanum, M. D., 
No. 20 Pubic Row. 
Date. 

The analysis of this prescription is as follows : 
Recipe, the imperative of recipio (I take), is put in this mood as it 
is a command to the apothecary ; the drug taken is the compound 
extract of colocynth the official name of which is extractum colocyn- 
thidis compositum, and which, according to Rule I., must be placed in 
the genitive ; by Rule III., the quantity takes the accusative, but in this 
case it is a fraction, and so the numeral only is made objective, and of 
a drachm takes the genitive, semissis becoming semissem, or of a drachm 
(gen.), a half* (ace), and lastly the numeral defining the quantity follows 
the noun defined. Blue pill, by Rule L, becomes massse hydrargyri, and 
one scruple, scrupulum unum, is placed in the accusative according to 
Rule III., governed by recipe. Extracti opii is parsed in the same 
way; grana, grains, takes the accusative plural, by Rule III., and sex 
is indeclinable and follows the noun it qualifies. Simple syrup, syrupi 
simplicis, is construed by the same rules, and quantum sufficiat 
(a sufficient quantity) is employed to allow the dispenser to use his own 
discretion as to the quantity necessary to complete the pharmaceu- 
tical details of the prescription. Misce, the imperative of misceo (I 
mix), signifies a command to mix the drugs ordered ; et is (and), in 
pilulas, into (pills), the preposition in governing the accusative plural ; 
viginti quatuor (twenty-four) is indeclinable, and divide is the impera- 
tive of divideo (I divide). Signa is the imperative of signo (I mark), 
and everything following this is written in English and transferred to 
the label. In daily practice Recipe becomes R, and the quantities are 
rendered by symbols, so that the student has chiefly to do with the 



PHARMACOLOGICAL REMEDIES. 71 

genitives of the Latin names of drugs. Should one official name only 
be used, the quantity or number follows the title which is put in the 
accusative (Rule II), as 3^ Pilulas Catharticas Compositas, xx. Plasters 
are written for thus : 3^ Emplastrum belladonnae, 3x5. S. Apply 
to painful spot. Prescriptions are always expressed in practice some- 
thing like the following : 

R Acid, carbolici, 5ij ; 

Alcoholis, 

Glycerini, aa, foj ; 

01. bergamot., gtt. ij. 

Aquae ad f§yj. M. S. — Use as a lotion. 
The "f" before any symbol signifies l< fluid," and of course is only 
used in the case of liquids. For the symbols and equivalent meas- 
ures see Weights and Measures ; and the Appendix for list and defi- 
nition of Latin words used in prescription writing. Parts of grains, 
ounces, etc., are expressed by common fractions. When ad (up to) is 
written before the last symbol, it means that the total amount is to be 
made (up to) the quantity expressed by that symbol. After misce y 
when a draught, lotion, etc., is ordered, it is expressed by fiat (con- 
tracted to ft.) haustus, ft. lotio, etc., meaning, let so and so be made. 

The following abbreviations are inexcusable, not to say danger- 
ous: Acid, hydroc, which may mean acidum hydrochloricum or 
hydrocyanicum ; acid, sulph. maybe mistaken for acidum sulphurosum 
or acidum sulphuricum ; hydrarg. chlor., which might be calomel, cor- 
rosive sublimate, or even chloral hydrate ; amm. is undistinguishable 
from ammonia or ammoniac; aq. chlor., from chlorine or chloroform; 
ext. col., from extract of colchicum or extract of colocynth ; and zinc 
phosph., from zinc phosphide or phosphate. A good rule is to express 
the word in full in case of doubt. 

AGE, DOSAGE, SEX, HABIT, AND OTHER CIRCUMSTANCES MODIFYING THE 
EFFECTS OF MEDICINES. 

A variety of circumstances, relating to the human organism, 
modify the effects of medicines. 

1. Age exerts a most important influence in this particular. 
Children are more susceptible than adults ; and in advanced age, also, 
smaller doses are required than in the prime of life. No general rule 
can be laid down for the adaptation of the doses of medicine to dif- 
ferent ages ; as the susceptibilities to the influence of different medicines 
are unequal at the same age. Thus, infants are peculiarly alive to 



72 MATERIA MEDICA AND THERAPEUTICS. 

impressions from opium, while in the cases of calomel and castor oil, 
they will bear much larger proportional doses. 

A good practical rule for graduating doses is that of Dr. Cowling : 
" The proportional dose for any age under adult life is represented 
by the number of the following birthday divided by twenty-four ; " 
for one year iz = t 1 ? ; for three years, -fa = I; for eleven years, M = i. 

2. Sex, temperament and idiosyncrasy all modify the effects 
of medicines. Women require somewhat smaller doses than men ; 
and during menstruation, pregnancy, and lactation, all active treatment 
which is not imperatively demanded should be avoided. To persons 
of a sanguine temperament, stimulants are to be administered with 
caution, while, in cases of the nervous temperament, the same care is 
to be observed in the employment of evacuants. Mercurials are 
called for where the bilious temperament exists ; but, on the other hand, 
they are generally injurious where the lymphatic temperament is 
strongly marked. Idiosyncrasy renders many individuals peculiarly 
susceptible or insusceptible to the action of particular medicines, as 
mercury, opium, etc. 

3. In disease, an extraordinary tolerance of the action of many 
medicines is established. In tetanus, immense quantities of opium 
are borne and required ; in typhoid fever, alcohol is freely adminis- 
tered without inducing intoxication ; in pneumonia, tartar emetic may 
be taken in large doses without nausea. 

4. The time of administration modifies the action of medicines. 
Where a rapid effect is desired, they are to be given on an empty 
stomach ; on the other hand, irritant substances, as the arsenical or 
iodic preparations, are best borne when the stomach is full ; and the 
insoluble chalybeates, requiring the gastric fluid to dissolve them, 
should be taken with the food. To counteract the collapse of low 
fevers, stimulants, in the early morning hours, are called for. 

5. The condition of the stomach is to be considered in pre- 
scribing medicines. In the black vomit of yellow fever absorption 
cannot take place by the stomach, and in the second stage of cholera 
endosmosis by the bowels is impossible ; here the hypodermic medi- 
cation is invaluable. 

6. Habit diminishes the influence of many medicines, especially 
narcotics. 

7. The influence of race, climate, occupation, and the imagi- 
nation upon the effects of medicines is often decided, and deserves 
attention in prescribing. 



PHARMACOLOGICAL REMEDIES. 73 

PARTS TO WHICH MEDICINES ARE APPLIED. 

Medicines are applied to the Skin, to Mucous Membranes, to 
Serous Membranes, to Wounds, Ulcers, Cysts, and Abscesses. 

1. To the Skin. — Medicines are applied to the skin for both a 
local and a general effect ; when brought into contact with the skin 
without friction it is termed the enepidermic method. A powder is ap- 
plied to the skin by being dusted on : a liquid, either medicated or 
simple, when employed to bathe a surface, is termed a lotion ; certain 
substances (as tincture of iodine) are painted on with a camel's-hair 
pencil, or they may be applied to the skin in the form of plasters, oint- 
ments, etc. As their influence on distant organs is the result of their 
absorption, this function must be taken into consideration. Solutions 
of medicinal substances in water permeate slowly through the skin to 
enter the vessels. M. Hebert first drew attention to the fact that the 
oily secretion of the sebaceous follicles of the skin prevented the con- 
tact of aqueous liquids with the cuticle, though the cuticle itself is the 
main impediment to absorption. Waller* found that chloroformic 
solutions of the alkaloids placed in contact with the skin readily pro- 
duced their effects upon the system. He ascertained that chloroform 
readily osmoses through the skin, carrying with it dissolved substances, 
and that the rationale of the process was not due to a solvent action 
on sebaceous matter. The system may be affected, too, through the 
skin by exposing it to the vapor of mineral substances, and to this 
method the term fumigation is applied. The drug mostly in use for 
this purpose is calomel in the treatment of syphilis. 

The application of medicines to the skin by friction is termed the 
epidermic method. If the remedy be in an oleaginous form, the term 
inunction is applied to it. Inunction is resorted to when it is desirable 
to spare the stomach or to bring the system surely under the influence 
of the remedy without disturbing the digestive system. Its action is 
slow and the method dirty, but often extremely efficacious. When 
we wish to affect the system through the agency of the skin, another 
method is to apply the medicine to the dermis denuded of the cuticle. 
This is termed the endermic method, and the cuticle is usually removed 
by means of a blister. The medicine is applied to the denuded dermis 
in the form of powder, or, if very irritating, it may be incorporated 
with gelatin, lard or cerate. This method is useful in cases of irrita- 

* The Practitioner, London, 1869, vol. iii, p. 330. 



74 MA TERIA MEDICA AND THERAPEUTICS. 

bility of the stomach, of inability to swallow, or where we desire to 
influence the system rapidly and by every possible avenue, or where 
it is of importance to apply the medicine near the seat of the disease. 
The dose is to be two or three times the amount which is administered 
by the stomach. 

Another means of applying medicines through the skin is by 
injection into the subcutaneous cellular tissue, and is termed the hypo- 
dermic method. Medicines are injected hypodermically for both a 
general and a local effect. A constitutional impression can be pro- 
duced by this means more certainly, rapidly, and efficiently than by 
the introduction of medicines into the stomach. It is particularly 
adapted to the speedy relief of pain, to the treatment of diseases in 
which it is desirable to influence the system Vith the greatest possible 
rapidity and effect, and also to cases where the internal administration 
of medicines is interfered with. The substances proper for hypodermic 
injection are those which are small in bulk and are of perfect solubility, 
such as the alkaloids, and these may now be had in the form of hypo- 
dermic tablets, of definite and accurate dose, and of ready aqueous solu- 
bility. When about to be administered, the tablet is placed in a tea- 
spoon, and from lT[x to xxx of pure water are poured over it ; it is then 
gently broken up and stirred until perfect solution is effected. The 
syringe must be freed from air before the injection is made. Substances 
of imperfect solubility should not be injected hypodermically, danger- 
ous results having followed therefrom. The dose, particularly in first 
injections, should be one-third of the ordinary dose by the stomach, 
and for females rather less. The proper dosage, however, can not be 
exactly stated, as habit, age, idiosyncrasy, and the nature of the disease 
must govern the amount required. As a precautionary measure, it is 
best to begin with the smallest dose. 

The instrument used for injection is a small syringe armed with a 
sharp tubular needle, and, for the better regulation of the dose, it is 
desirable that the syringe should be graduated. Before making the 
injection, a site should be chosen free from superficial veins, and where 
the skin is loose and extensible. Having pinched up a fold of the 
skin, or rendered it tense and flat, the needle is boldly thrust in until 
resistance ceases, and emptied slowly as it is withdrawn, the tiny punc- 
ture being closed for a moment with a finger-tip. It is important to 
avoid the puncture of a vein, lest a suddenly overwhelming effect be 
produced ; and, with this view, the syringe-needle should not be 
pushed too deeply into the tissues, and should be withdrawn a little to 



PHARMACOLOGICAL REMEDIES. 75 

allow a wound of a vein to close from elasticity. When a constitu- 
tional effect only is aimed at, non-sensitive, vascular parts should be 
selected, in order to facilitate absorption and give little pain, such as 
the waist ; another good spot for injection is at the insertion of the 
deltoid muscle, or into the radial border of the forearm, and, where 
repeated operations are practiced, it is well to vary the point of injec- 
tion. Irritating injections are best tolerated in the back. To preserve 
hypodermic solutions from the destructive action of a low order of 
vegetation (algae), cherry laurel-water or a weak borax solution should 
be used. Medicines are injected subcutaneously for a local effect when 
it be desirable to produce anaesthesia or other action in a circumscribed 
part. Means must be taken to prevent the injected fluid from entering 
the general circulation (as by a ligature). Solution of cocaine is the 
medicament usually employed. 

2. To Mucous Membranes. — Medicines are applied to all the 
gastro-pulmonary and genito-urinary mucous surfaces, either in solu- 
tion or solid form. 

a. To the conjunctiva they are applied for local effects only, and 
are termed collyria, or eye-washes. As a rule their strength should 
be weak when first used ; they may be mydriatic, myotic, astringent, 
antiseptic, caustic or soothing. Collyria are usually applied by means of 
a pipette with a rubber-bulb ; if not at hand a teaspoon may be used. 
The head should be bent backward, the lower lid drawn down, and 
the fluid dropped into the lower cul de sac of the conjunctiva. If 
necessary, as in purulent cases, the conjunctival sac may be flushed 
out by squirting in the fluid from a rubber-syringe. Oils may be 
applied by a pipette ; ointments smeared along the free margins of 
the lids ; or, if intended for the cornea, a bit the size of a pin's head 
should be applied directly to it. Powders are applied to the eye from 
a camel's-hair pencil. Soluble gelatin-disks are employed to bring 
slowly and continuously in contact with the eye various remedies, as 
atropia, cocaine; etc. While absorption is progressing the lids should 
be closed. 

b. To the nasal or pituitary membrane, they are applied usually 
for local purposes, in solution, and termed a douche, which should be 
warm, and thrown in from a special syringe with a conical nozzle ; 
sometimes, however, to irritate and excite a discharge, when they are 
termed errhines (now rarely used) ; sometimes, also, in the form of 
powder either as a medicament or to produce sneezing, and if for the 



76 MATERIA ME PICA AND THERAPEUTICS. 

latter purpose with a view to the expulsion of foreign bodies from the 
nasal cavities, they are termed sternutatories. 

c. To the mucous membrane of the mouth and throat, medicines are 
applied almost exclusively for local purposes. A favorite method of 
bringing a remedy in contact with the parts around the throat is the 
troche, or lozenge. When in solution, such remedies are termed gargar- 
ismata, or gargles. In gargling* the first and second acts of degluti- 
tion are completed ; but as the fluid is about to betaken into the oesopha- 
gus, it is either gurgled in the throat, or ejected per orem ; and it is 
while so held, that its physiological operation is put in play. Gargling 
is unreliable in the following morbid conditions of the throat : cancer, 
paresis, and torticollis ; and, lastly, it is not efficiently done by all 
alike. Liquids maybe also applied to the throat and tonsils by means 
of a sponge-holder, and by spray (q. v.) ; solids, upon a porte-caustic. 
Powders are introduced by insufflation, from an insufflator. 

d. To the Eustachian tubes, liquids are occasionally applied in 
local affections, but they are of doubtful utility. 

e. To the external auditory canal (though not a mucous canal, 
considered here for convenience of study), medicines are introduced by 
means of a syringe, instillation, insufflation, cotton-holder, or, on zporte- 
caustic. If, in the form of powder, which is the method preferred 
by otologists when there is a discharge from the meatus, the agent 
should be finely pulverized, and introduced by an insufflator. Solu- 
tions are brought into contact with the auditory canal by instillation, 
or, a syringe. When the former method is employed, a medicine- 
dropper is used ; the ear must be cleansed, dried, the head bent for- 
ward and leaned toward the opposite shoulder. To syringe the audi- 
tory canal, Burnettf gives the following directions : the water must be 
warm, the syringe should have a conical nozzle, there should be a vessel 
to catch the return-water, and the syringe is to be pointed forward, 
downward, and toward the patient's nose. In applying remedies to the 
auditory canal, the condition of the membrana tympani, as regards 
permeability, must be considered. 

f. On the atrial or tracheobronchial membrane, medicines produce 
a very decided influence, both local and general. Liquid substances 
are introduced into the upper air-passages by atomization and inhala- 
tion, in the treatment of inflammations of the larynx, trachea, and lungs. 

* See Hand-book of Local Therapeutics, 1893; Dr. H. Allen, 
f The Ear, 2nd ed., p. 171. 



PHARMACOLOGICAL REMEDIES. 77 

Within the last few years, liquids have been introduced or thrown 
into the air-passages for the treatment of diseases of the respiratory 
organs, in the form of spray, either coarse or fine. This mode of appli- 
cation, termed the atomization of fluids, has proved very valuable, 
particularly the coarse spray, in the relief of nasal and naso-pharyngeal 
affections ; the fine spray is best suited to the larynx and lungs. Various 
instruments have been resorted to in the atomization of liquids. The 
hand-ball atomizer, which is usually employed, consists of two glass- 
tubes, with capillary openings, placed at right angles to each other, the 
vertical tube being dipped in a bottle containing the fluid to be atomized, 
while at the other end it is close and about opposite to the centre of a 
capillary opening in the horizontal tube. This connects with an elastic 
tube, intercepted by two elastic balls, one in the middle, the other, 



Fig. 2. 




THE HAND-BALL ATOMIZER. 



which is furnished with valves, at the end of the tube. The upper ball 
acts as a reservoir, into which a current of air is forced from the lower 
ball by pressure with the hand. The air in the vertical glass-tube 
being rarefied, the liquid rises to the capillary opening, and is there 
pulverized by the current of air from the horizontal tube. In Snow- 
den's atomizer there is but one tube through which the fluid is forced 
and broken into a fine spray at the tip. To Sajoics' pharyngeal atom- 
izer there is a tongue-depressor attached, so that the patient can use it 
without assistance. 



78 MATERIA MEDICA AND THERAPEUTICS. 

Irritating substances should be guardedly applied to the upper 
air-passages, particularly the larynx, and before active treatment is in- 
stituted the membrane should be cleansed, for which purpose there is 
nothing better than to spray the parts with Dobell's solution.* 

Other medicaments well adapted to atomization are zinc sulphate 
gr. iij-v to aq. f$j ; tannin, gr. v; borax; boracic acid; silver nitrate; 
decolorized tincture of iodine, foi, to water fSj; tar water; potassium 
permanganate, etc. The atomizer is used also to produce local anaes- 
thesia, and as a deodorizer. 

As modified by Sass, by means of differently shaped tubes, the 
spray can be readily generated within various parts of the body, as 

Fig. x. 



SASS' SPRAY TUBES. 



the back of the throat, nostrils, meatus of the ear, etc. An inhalant is an 
agent, mostly volatile, diffused into the respired air from solution, more 
or less complete, and drawn into the air-passages by the act of breathing. 
Steam is chiefly used as the diffusive power, and the apparatus employed 
is that known as Siegle's steam atomizer or inhaler. In this instru- 
ment, inhalation can be practised without fatigue or assistance, and the 
warmth and moisture of the spray is also an advantage in many diseases 
of the respiratory organs in allaying irritation and relieving dryness. 
The emanations of many remedies, as iodine, tolu, etc., may be inhaled 
from a tumbler of boiling water, the vapor from which is respired 
through the end of an inverted paper-funnel. Various substances are 
inhaled with advantage in phthisis, chronic bronchitis, laryngitis, 
asthma, etc., while the most powerful effects are produced on the sys- 
tem by the absorption of anaesthetic vapors through the pulmonary 

* R Acidi carbolici liquidi, TTL XXX ; 

Sodii biboratis, 

Sodii bicarbonatis, aa ^j ; 

Glycerini, f ^iijss; 

Aquae, ad ^5^. M. 

Sic — To be used in atomizer. An excellent cleansing spray in acute and chronic 
nasal catarrh ; also as a mouth-wash in fetor of breath. 



PHARMACOLOGICAL REMEDIES. 79 

mucous membrane. The volatile oils, camphor, dilute glycerite of 
tannin, and potassium chlorate are suitable for steam atomization or 
inhalation. 

g. The gastro-intestinal mucous membrane, of all parts of the body, 
is most employed for the exhibition of medicines. The stomach, from 
its great vascularity, its solvent secretions, and the numerous relations 
which it has with almost every part of the body, is the chief recipient 
of medicinal agents. The rectum is, however, also frequently employed 
for various purposes, as to relieve disease of this or of neighboring 
organs, to occasion revulsion, to produce alvine evacuations, to destroy 
ascarides,and when, for any reason, it is desirable to spare the stomach. 

It is usually recommended that the dose of medicines introduced 
into the rectum for constitutional effects should be two or three times 
greater than when taken into the stomach. In the case of active, 
soluble medicines, however, especially narcotics, it is most prudent to 
give at first the same amount by the rectum as by the mouth. 

Solid substances introduced into the rectum are termed supposi- 
tories. Liquids introduced into the rectum are termed clysters, lave- 
ments, injections, and enemata. (See enemata). Soluble substances, 
when thus applied, are usually dissolved in water; insoluble substances, 
are suspended in some mucilaginous vehicle. When the enema is to 
be retained, it should not exceed f siij in quanity. When it is intro- 
duced to act upon the bowels, its bulk may be from f oxij-xyj for an 
adult, fSyj-viij for a youth of twelve, f§iij-iv for a child of one to five 
years, and f §j for a newly-born infant. Various syringes are used for 
the administration of enemata, the fountain or enema-syringe with 
hand-bulb, being among the best. Gaseous matters have also been 
thrown into the rectum, tobacco smoke for example, to relieve obstruc- 
tion of the bowels. As the rectum is not a digestive tube, when 
food is to be introduced by this channel, the essentials for the carrying 
on artificially of digestion must be added ; viz., to beef-tea f o'w add 
hydrochloric acid TTlx, and glycerole of pepsin f5ij- Defibrinated 
blood, too, as a restorative agent, has been injected into the rectum 
after uterine hcemorrhage , with success (Leon).* 

h. To the vagino-uterine and urino-genital mucotis membranes ap- 
plications are made exclusively for local purposes. In the form of 



* Valor Terapeutico de Los Enemas de Sangre Deofibrinata ; Gaz. Med. Cat., 1886, ix, 
711. 



80 MATERIA MRDICA AND THERAPEUTICS. 

solution they may be brought in contact with the vagina by means of 
a long-nozzle syringe ; or by the insertion of a vaginal suppository. 
Within a few years intra-uterine medication has been a good deal em- 
ployed in local affections of the uterus; but in the injection of fluids 
into the uterus there is danger of metro-peritonitis. The pendulous 
portion of the male urethra can be readily reached by the ordinary 
injection ; or, it may be slowly medicated by soluble gelatin-bougies. 
Solutions of medicinal substances warmed are forced into the bladder 
in chronic cystitis, etc., to the extent of fSiv-yj, by a rubber-catheter 
and syringe. 

3. To Serous Membranes. — Irritating solutions are injected into 
the cavity of the tunica vaginalis testis, in hydrocele ; into the hernial 
sac, in hernia ; and into the pleural cavity, in pleurisy, for the purpose 
of producing adhesion of the sides of the sacs. 

4. To Ulcers, "Wounds, and Abscesses, medicines are applied chiefly 
for their local effects. The absorbing power of these surfaces is to be 
kept in mind in such applications. Cysts are sometimes cured by in- 
jections, as of tincture of iodine into cysts of the thyroid gland. 



THE CLASSIFICATION OF MEDICINES. 

In treating the articles of the Materia Medica some writers have 
classified them according to their natural properties, others according 
to their action on the human system. To the student of medicine a 
classification based upon the sensible qualities or natural affinities of 
medicines can be of little value, since it associates articles of the most 
opposite remedial properties. A classification of medicines founded 
on a similarity of action on the animal economy is more desirable and 
useful, and various arrangements of the Materia Medica have been 
attempted on this basis. They are all, to some extent, necessarily 
imperfect, owing partly to the diversified effects of medicines and 
partly to our ignorance of the real nature of many of the modifications 
which they produce upon the tissues. Still, the advantages of some 
arrangement of this kind are so numerous that it cannot well be dis- 
pensed with. 

The following classification will be found to include the more 
ordinary and generally received divisions of the Materia Medica, and 
to present the articles in convenient groups for therapeutic application. 

Medicines may be divided into — 



PHARMACOLOGICAL REMEDIES. 



81 



Those which have a special action on the nervous system, or 
Neurotics (from vevpov, a nerve). 



II. 



III. 



Those which have a special action on the secretions, or 
Eccritics (from 'eKuplaig, secretion). 



Those which modify the blood, or Hce?natics (from aljua 
the blood). 



Ilia, J 



IV. Those which act topically. 



Narcotics, 
Anaesthetics, 
Antispasmodics, 
Tonics, 
Astringents, 
Stimulants, 
Sedatives, 
Spinants, 
Emetics, 
Cathartics, 
Diaphoretics, 
Diuretics, 
Blennorrhetics, 
Emmenagogues. 
Haematinics, 
Alteratives, 
Antacids. 
Antiseptics, 
Irritants, 
Demulcents, 
Protectants and Absor- 
bents, 
Coloring Agents, 
Anthelmintics. 



CLASS I.— NEUROTICS. 



ORDER I. — NARCOTICS. 

Narcotics (from vapxow, to stupefy) are medicines which impair 
or destroy nervous action. The primary effect of narcotics is, how- 
ever, of a stimulant character, and their therapeutic efficacy is in a 
great degree due to this action. They are often administered, too, 
for a true narcotic or sedative influence on the motor, sensory and 
intellectual functions. In diseased conditions, a marked tolerance 
of this class of medicines is established, and they can be exhibited 
in large doses without inducing narcosis. They are employed, chiefly, 
to remove muscular spasm, relieve pain, allay cerebral or spinal 
irritability, and procure sleep. 

When employed to relieve pain, they are termed anodynes; 
when employed to procure sleep hypnotics or soporifics. 

When this class of medicines is resorted to for any length of 
time, with a view to a narcotic effect, their influence upon the system 
is much diminished, and constantly increased amounts are called for 
to maintain the same effect. 
6 



82 MATERIA MEDICA AND THERAPEUTICS. 

OPIUM. 

Description, Habitat and Varieties. — Opium (from o,toc Juice) 
is the concrete milky exudation of the unripe capsules of Papaver 

Fig. 4. 




POPPY-CAPSULE. 



somniferum (Nat. Ord., Papaveraceae). The opium-poppy is a native 
of Persia, but is cultivated in various parts of Asia, in Europe, and in 
the United States. The commerce of the United States Is supplied 
with opium almost exclusively from Asiatic Turkey. This is known 
in the market as Smyrna or Turkey opium, and comes in irregularly- 
rounded or flattened cakes, covered with the capsules of a species of 
Rumex. A large amount of opium is produced in British India, for 
consumption in India and China ; but it is not found in our markets. , The 
Persian opium is another variety, as is that obtained from upper Egpyt; 
but these do not reach the United States. It is an annual plant, with 
a round, leafy stem, from two to four feet or more in height, and large 
four-petaled flowers. There are two prominent varieties of this species : 
the black poppy, with violet-colored or red flowers, brown or blackish 
seeds, and globular capsules ; and the white poppy, with white flowers 
and seeds, and ovate capsules ; but these varieties run into each other 
under cultivation. 

The nearly ripe capsules (papaver) are from an inch and a half 
to two inches or more in diameter, and contain a good deal of opium. 
They are sometimes given to children in the form of syrup, and are 
applied externally as an anodyne emollient, in the form of decoction. 
The seeds are destitute of narcotic properties, and are used in Europe 
as an article of diet, and for the manufacture of an oil. 

Opium is obtained from incisions in the half-ripe capsules. The 



NAR CO TICS— OPIUM. 83 

juice which exudes from the incisions is allowed to evaporate sponta- 
neously, and is scraped off after drying, generally with more or less of 
the epidermis, and is sometimes sent into the market unmixed, as a 
choice variety. The opium of commerce is, however, commonly made 
by adding the dried juice, obtained by incision, to an extract prepared 
by expression, or even from a decoction of the leaves, the whole being 
kneaded together, formed into cakes, and wrapped in fresh poppy- 
leaves. 

Properties. — The best opium should have a fine chestnut color, 
an aromatic, strong, peculiar smell and a dense consistence — becoming, 
however, harder and darker by being kept. It should be moderately 
ductile, break with a deeply-notched fracture, and, when drawn across 
white paper, should leave an interrupted stain. The taste is very bit- 
ter and somewhat acrid. It is inflammable, and imparts its virtues to 
water, alcohol and diluted acids, but not to ether. 

Chemical Constituents and Tests. — Opium contains a great 
variety of chemical constituents, the most important of which is the 
alkaloid Morphina {morphine). Other principles found in opium are 
the alkaloids, narcotme, codeine, narceine, paramorphine (thebaine), 
papaverine, pseudomorphine (phormine) ; meconin, meconic and the- 
bolactic acids, gum, extractive, resin, oil, etc., but no tannin or starch, 
and, in very minute amounts, alkaloids, termed meconidine, laudamine, 
codamine, lanthopine, rhceadine, laudanosine, protopine, xanthaline, 
hydrocotarnine, deuteropine, oxynarcotine, gnoscopine, and cryptopine. 
Porphyroxin, so called by Merck, is not a proximate principle, but a 
complex substance, consisting of several alkaloids (Hesse). Morphine 
is the principle upon which the narcotic effects of opium essentially 
depend, and, with its salts, is official in all the pharmacopoeias. 

Morphine exists in opium chiefly in combination with meconic 
acid. The morphine meconate is separated from the other constituents 
of the drug by successive macerations with water. Alcohol and 
water of ammonia are then added to the aqueous solution, by which 
the salt is decomposed, the ammonia precipitating the morphine and 
the alcohol seizing the coloring matter as soon as it is separated from 
the alkali. The crystals of morphine which are formed are afterwards 
boiled in alcohol, and the solution is filtered through animal charcoal. 
Good samples of opium when dried should yield not less than 13 nor 
more than 1 5 per cent, of morphine. 

Morphina {Morphine) (C 17 H 19 N0 3 +H 2 0) occurs in colorless, rhom- 
bic, prismatic crystals, without smell, but of very bitter taste, and al- 



£4 MATERIA MEDIC A AND THERAPEUTICS. 

kaline reaction. It is very slightly soluble in water and ether, nearly 
insoluble in chloroform, sparingly soluble in cold and more soluble in 
boiling alcohol. Acetic acid (ethyl acetate) is the best solvent for it. 
From the insolubility of the alkaloid the salts of morphine are pre- 
ferred for medical use; they are freely soluble in water and diluted 
alcohol, but are insoluble in ether and chloroform. Tests: I. Con- 
centrated nitric acid strikes with morphine and its salts a rich orange- 
red color, slowly fading to yellow ; this will detect gr. roo^c in the dry 
state (Wormley). 2. Neutral solution of ferric chloride or sulphate 
colors them deep blue. Other tests are recommended, but these are 
the best. 

Narcotine (C^H^NOj) exists in opium, chiefly in the free state, 
and, being insoluble in water, is left behind when the drug is macerated 
in this menstruum. It occurs in white, tasteless, inodorous, needle- 
like crystals, which are soluble in ether, alcohol, and still more so in 
chloroform. At one time it was thought to possess a portion of the 
narcotic properties of opium, but it is now admitted to be inert in this 
respect. Its salts, which are bitter, have been used in India as stom- 
achics, and as febrifuge tonics in the treatment of intermittent fever. 

Codeina [Codeine) (C 18 H 21 N0 3 +H 2 0) exists in opium combined, 
like morphine, with meconic acid, and is extracted in the process for 
obtaining the latter alkaloid, from which it may be separated by an 
alkaline solution, which dissolves the morphine and leaves the codeine. 
It occurs in colorless, octahedral crystals, of a bitter taste, soluble in 
water, alcohol, ether and chloroform. 

Narceine (C 23 H 29 N0 9 ) is obtained from the mother liquid left after 
crystallizing out the salts of morphine. C. Bernard affirms that it is 
the most certain hypnotic of all the opium alkaloids. Da Costa's ex- 
perience shows that it has little effect on skin or pupil, and that its 
hypnotic action is uncertain or inert, while Eulenberg asserts that to 
get its hypnotic effects it must be given in doses twice as large as 
morphine. 

Paramorphine (Thebaine) (C 19 H 21 N0 3 ) is a tetanizing toxic agent, 
analogous in its effect to strychnine. 

Papaverine (C 21 H 21 N0 4 ) is said to produce some soporific action 
with a sedative influence on the pulse ; its strength is from one-eighth 
to one-fourth of that of morphine. 

Cryptopine (^H^NC^) is thought to produce an hypnotic influ- 
ence analogous to that of morphine, though a much feebler agent The 
statements in regard to the action of the last four alkaloids are con- 
flicting. 



NARCOTICS— OPIUM. 85 

Meconic acid is inert, but is interesting as affording the most deli- 
cate test for opium ; ferric chloride or sulphate produces, with even 
very diluted solutions of opium, the blood-red color of ferric meconate, 
which is not discharged by diluted acids or corrosive sublimate. 

Incompatibles. — Alkalies, and astringent infusions containing tan- 
nic acid, are incompatible with opium; the former precipitate morphine 
from its soluble combination, while the latter form with it an insoluble 
compound. Iodine and the iodides, bromine and the bromides (after 
standing) produce precipitates with the morphia salts, an iodide or 
bromide of the alkaloid being formed. A few drops of dilute HClacid 
added to the bromide mixture will effect solution. Sodium biborate 
throws down a precipitate with the salts of morphia, cleared up by 
boric acid. Many of the mineral salts are also decomposed by opium, 
as lead acetate (lead meconate and morphine acetate being formed). 
This chemical incompatibility, however, does not interfere with the 
physiological action of opium ; for instance, lead acetate and laudanum, 
though incompatible, produce a local sedative effect ; moreover, lead 
acetate, opium or the morphine salts may be safely prescribed together 
in pill form. 

Aids. — Its hypnotic action is aided by the bromides, chloral, 
sulphonal and paraldehyde ; its analgesic, by belladonna and cocaine ; 
but it should not be prescribed in full doses with these agents. 

Contraindications. — It is positively contraindicated only where 
there is a tendency to apoplexy or coma, where the opium habit exists, 
where asphyxia is threatened by copious secretions in the air passages, 
or where there exists an idiosyncrasy with respect to its effects. 

Physiological Effects. — Opium depends chiefly on the pres- 
ence of morphine for its physiological activity. Opium applied locally 
deadens the sensibility of the nerves of a part without influencing the 
brain [Trousseau et Pidoux, vol. ii.). In detail its physiological action, 
' in moderate doses is as follows : Its taste is bitter, and when introduced 
within the mouth.it excites irritation in that cavity and in the throat. 
Secretions : the intestinal secretions are diminished, and, as peristaltic 
action is retarded, constipation results ; the urine is slightly diminished, 
as is also the saliva; in one word all the secretions are lessened except 
that of the skin, which is increased. Nervous system : the cerebral 
functions are stimulated, accompanied by an agreeable exhilaration of 
the intellectual faculties, followed by drowsiness, consciousness being 
finally lost in sleep, the latter sometimes disturbed by dreams. Such 
sequelae as headache, nausea and constipation are common. The reflex 



86 MATERIA MEDICA AND THERAPEUTICS. 

function of the spinal cord is diminished, and in lethal doses destroyed, 
death taking place from paralysis of the respiratory centre. Pupil : in 
full doses opium contracts the pupil ; but, since the local application of 
morphine scarcely possesses this power, it follows that its action must 
be systematic, due probably to stimulation of the oculo-motor centres. 
Circulation : the heart's action becomes slower and fuller, from a de- 
pressing influence on the cardiac motor-ganglia ; at the same time the 
arterial tension is raised. Respiration : this becomes slower, and the 
bronchial mucus is lessened. Elimination : in regard to its elimination 
by the kidneys, Eliasson's* conclusions are as follows, viz., that large 
doses only can be found in the urine, small being undetectable, though 
there appears with the latter in the urine a supposed morphia-deriva- 
tive. According to Phillips the drug is partly eliminated by the skin. 
In some persons an itching and miliary eruption of the skin occurs. 
Most of the opium alkaloids increase the excretion of urea. 

To sum up, opium, in man, expends its force chiefly on the higher 
cerebral centres, scarcely influencing the cord at all, unless in full doses; 
while in the lower animals whose cerebra are undeveloped, as the frog, 
it acts wholly on the cord, and in them, in the absence of a well-devel- 
oped brain, hypnotism is unusual. According to Fothergill, opium 
produces sleep by causing cerebral anaemia and diminished activity of 
the cells, and is analgesic by lessening the conductivity of nerve- 
matter. 

Toxicology. — When a poisonous dose is taken, the stage of excite- 
ment is wanting; giddiness and stupor rapidly come on, with diminu- 
tion in the frequency, though not in the fullness of the pulse ; and 
these symptoms are soon followed by an irresistible tendency to sleep, 
and finally by coma. The breathing is heavy and stertorous, the pulse 
slow and oppressed, and the pupils are contracted. If relief be not 
afforded, the pulse sinks, the muscular system becomes relaxed, and 
death ensues, preceded sometimes in children by violent convulsions. 
In adults even gr. ^ of morphine,f hypodermically, and gr.ivss of 
opium,! have caused death; but such results are rare. On the other 
hand, enormous amounts (laudanum § fSvij, and in the case of a girl 
aged nj^, || f3xij) have been taken without fatal consequences. 

* Beitrage zur Lehre von dem Schicksal des Morphins im Lebenden Organismus. 
Inaug. Dissertation, Konisberg, 1882, von W. Eliasson. 
f Chicago Med. Exam., May, 1878, p. 493. 
$ A Treatise on Poisons, 4th ed. p. 713, by Christison. 
\ Med.-Chir. Trans., Vol. I, p. 77. 
|| Guy's Hospital Reports, XI, 1865, p. 287. 



NARCOTICS— OPIUM. 87 

Antidotes. — In cases of poisoning from opium or its preparations, 
the stomach should be immediately evacuated by the stomach-pump, if 
possible, or by emetics. Owing to the torpor of the stomach, emetics 
are to be given in double the ordinary doses, and the direct emetics are 
to be preferred, as zinc sulphate (gr. xx-xxx) or copper sulphate (gr. v-x), 
in a tumbler of water. A large tablespoonful of mustard flour, or of 
powdered alum, answers very well as an emetic, or apomorphine hydro- 
chlorate (gr. tV) may be given hypodermically. Every means should 
be taken to arouse the patient from his lethargy; he should be kept 
awake, and made to walk as long as possible ; afterward cold affusions, 
counter-irritations to the nape of the neck and extremities, flagellation 
to the palms of the hands and soles of the feet, and, best of all, when 
the coma is profound, the electro-magnetic battery should be resorted 
to, one electrode to be placed above the origin of the phrenic nerves, 
the other over the epigastrium. Artificial respiration is also to be 
practised. The use of strong coffee has proved efficacious ; and stimuli 
may be given to support the system. It has been found that atropine 
exercises a powerful influence as a physiological antidote to opium, 
these drugs acting in an opposite ma7iner on respiration, brain, skin, pupil 
and circulation. A hypodermic injection of atropine sulphate, gr. ^ to 
6*0, should be administered when there is any sign of the failure of res- 
piration, and repeated in fifteen to thirty minutes, the frequency and 
dose depending on the condition of the respiration, not of the pupil or 
depth of coma. Potassium permanganate should be tried as an anti- 
dote. The poisonous action of opium appears to be entirely directed 
to the nervous system, since no local lesions are found after death. 

Opium is largely used as an habitual narcotic in Oriental countries, 
and to some extent in Europe and the United States. The effects of 
indulgence in this species of intoxication are of the most destructive 
character upon both the physical and mental faculties. A confirmed 
opium smoker can be recognized, generally, by his pallor, emaciation, 
and pupil, which is dilated, except when under the influence of the 
drug. 

In China, extensive establishments are devoted to the smoking of 
opium (an extract), a form of dissipation that has fewer evils following 
in its train than those caused by the abuse of alcohol ; in fact, the " pipe " 
puts the smoker to sleep, and so effectually prevents the crimes so often 
induced by alcoholic inebriation. It is quite possible to indulge in the 
" pipe " and yet enjoy good health, and there are many Chinamen 
who, smoking in moderation, experience no evil effects therefrom. In 



88 MATERIA MEDICA AND THERAPEUTICS. 

Japan opium smoking is unknown, as the importation of the drug is 
rigorously prevented by law. As opium is either taken by means of 
the pipe, hypodermic injection, or in solution, the expression " opium 
eating " is a misnomer. 

Medicinal Uses. — Opium exerts a marked therapeutic action in 
the relief of pain, spasm, wakefulness, nervous irritability, and certain 
forms of morbid discharge, especially from the alimentary canal, by a 
primary stimulant action, antecedent to any narcotic influence. In 
such conditions a tolerance of its effects is established, and very large 
amounts may be taken without inducing narcosis. Of all the articles 
of the Materia Medica, opium enjoys the widest range of therapeutic 
application. From its properties of assuaging pain and inducing sleep 
it is useful in almost all diseases, and should be given in doses suffi- 
ciently large to produce a decided effect. As an anodyne in all injuries, 
as sprains, railway accidents, burns, etc., to relieve pain and resist sur- 
gical shock, we have no substitute for opium; and as an hypnotic in 
delirium tremens and in the insomnia and cerebral irritability of fever, 
mania, mania a potu, rabies, to control the spasms of teta?ius, and to 
relieve the bone-pains of dengue, either opium or morphine, the latter 
hypodermically, are invaluable : when given to induce sleep, etc., the 
disagreeable after-effects of morphia must not be lost sight of. Prior 
to an operation to avert surgical shock, gr. %-% of morphine may be 
thrown under the skin before etherization. In delirium tremens, when 
the arterial tension is high, to enhance its hypnotic effect, it is well 
combined with sedatives, as the bromides, chloral or aconite, as in the 
following: — 1^ Morphinae sulphatis, gr. %-% ; chloral, gr. xv ; syrupus 
tolutani, t5ss ; aquae, ad Sss. M. S. One dose. 

From its power of relaxing muscular spasm it is our most 
efficient resource in colic, either biliary, renal, intestinal or uterine, be- 
ing preferably given hypodermically, and often with atropine. 

In the early stage of acute dysentery, cholera and cholera morbus, 
opium forms the basis of every variety of treatment, partly for its 
diaphoretic effects, but principally for its action in arresting the intes- 
tinal secretions and peristalsis. In the collapse of cholera, Dr. 
Gallagher has derived great benefit from morphine subcutaneously. 
In dysentery, extract of opium gr.ss is given every two hours, con- 
tinued until an impression is made, or it becomes contraindicated ; or 
laudanum may be combined in the first stage with castor oil or Ro- 
chelle Salt (see Sal Rochelle) ; again, opium is often added to astrin- 
gents, vegetable or mineral, and lastly, it may be introduced within the 



NARCOTICS— OPIUM. 89 

rectum, either in starch-water or suppository, as a curative measure, or 
for the relief of the tenesmus. In conj unction with the above treatment, 
the patient should be placed upon a stimulating fluid diet, as milk and 
brandy. In some cases of dysentery it has been found that opium 
causes retention of the dejecta, which, by fermenting, irritate the 
bowel, hence it may at times do harm.* In acute diarrhoea, preferably 
after the exhibition of a cathartic, opium is indicated with a vegetable 
astringent: — 3^ Tincturse opii deodoratae, TT[x; tincturae kino vel cate- 
chu, f5j-ij ; aquae cinnamomi, f§ss. M. Sig — Every three or four 
hours ; or if accompanied with flatulency — 3^ Extracti opii, gr. y^ ; 
pulveris camphorae, gr. iij ; oleoresini capsici, gr. ^ ; M. Ft. pil. No. i. 
Sig. — Every three hours. 

In that form of diarrhoea where the motions quickly follow after 
eating, it is particularly serviceable by restraining peristalsis, thus 
allowing time for digestion. In peritonitis, as that of typhoid fever, in 
which large amounts are well borne, morphine hypodermically should 
be administered from the first, and the patient later kept narcotized by 
opium itself; while in puerperal septicemia it has been found more 
successful than any other remedy. In gastric irritability ', to check 
vomiting, to relieve the pain of rheumatism and gout, opium or mor- 
phine are constantly employed, and hypodermics of morphine in 
myalgia, lumbago, torticollis, and the various neuralgiae are the best 
means of alleviating the pain, and not infrequently effect a cure. The 
combination of morphine gr. y& with cocaine and belladonna is said by 
Ewald to relieve the pain of mild attacks oi g astro dynia ; if severe, 
the morphine must be given hypodermically. fn meningitis, cerebral 
or spinal, it is of the greatest value, no other drug being com- 
parable to opium, of which gr. ss-ij may be given hourly, so as to 
keep the patient thoroughly under its influence. In other con- 
vulsive diseases, such as urcemic convulsions (Loom is) and puerperal 
eclampsia, it is' an efficient remedy. An approaching paroxysm of 
malarial fever, pernicious or intermittent, may be prevented, if neces- 
sary, by the timely injection of morphine. 

To check peristalsis and relieve pain, opium or morphia are our 
most reliable agents in enteritis, intussusception and typhlitis. In hcema- 
temesis or intestinal hcemorrhage they place the stomach or bowel in 
splints as it were, and thus insure that quietude which is so needful for 
repair, while in intussusception, as an aid to surgical measures, full doses 

* See the Med. and Surg. Hist, of Rebellion, chap, on Dysentery. 



90 MATERIA MEDICA AND THERAPEUTICS. 

of either, well combined with belladonna, are indicated to allay the pain 
and quiet the spasm. In the relief of after-pains morphia or atropia 
are the best anodynes, care being taken to free the uterus of clots with 
ergot at the time of their administration. 

For the relief of the cough of pulmonary affections, as acute 
bronchitis, opium and morphia have no equal in the Materia Medica, 
but are generally contraindicated before the secretions are established, 
except in minute doses combined with a diaphoretic, as in Dover's 
powder. Good formulae are : E* Morphinse sulphatis, gr. ij ; syrupus 
ipecacuanhas, f5ijss; syrupus pruni virginianae, ®ij; aquae ad fSyj. 
M. et Sig. — Tablespoonful every three hours. ^ Tincturae opii cam- 
phoratae, glycerini, et syrupus pruni virginianae, aa, foj. M. et Sig. — A 
teaspoonful as necessary. For the cough of hcemoptysis, opium must 
be freely given. 

In the first stage of pleurisy, morphine hypodermically, together 
with aconite and a large dose of quinine per orem, and perhaps a 
blister, is the best means of relieving the pain and cough and hinder- 
ing effusion. 

Morphine subcutaneously will generally relieve a paroxysm of 
asthma and angina pectoris, and the dyspnoea of emphysema, although 
without curative power, and Dr. Allbutt recommends it to alleviate 
cardiac dyspnoea, which statement the editor can confirm. Thus given 
it affords the most relief for nocturnal chordee. It is the best remedy 
for the head and back-symptoms of influenza. In the initial state of 
small-pox the hypodermic injection of morphia relieves the insomnia 
and pain in the back. The griping, intestinal pain of cholera morbus, 
and the pain of gout are best controlled with hypodermics of morphia 
and atropine. A hypodermic of morphia relieves the pain of pleuro- 
dynia. 

In sunstroke, too, good results have been obtained from morphine 
injections with antipyretic and sedative treatment (Dr. James Hutch- 
inson). Opium, and its alkaloid codeine {see p. 93), have been highly 
lauded in the treatment of diabetes mellitus, diabetics tolerating large 
doses of opium well. Bruce, Frazer, and others, consider morphia 
the more efficacious remedy. To begin with gr. y 2 of codeine, and 
gr. i of morphia may be given t. d., gradually increased. In the 
therapy of this disease drugs play a secondary part compared with 
diet* 

* See Recife's Diseases of the Kidneys for a diet suitable to diabetics. 



NARCOTICS— OPIUM. 91 

Caution must be enjoined in prescribing opium or morphia in 
chronic diseases for fear of originating the opium or morphia-habit, 
which may be contracted where there is much suffering, on account of 
the speedy relief afforded by it. The treatment of the morphia-habit, 
which is best carried out in an institution, consists in isolation, regular 
feeding, and a gradual withdrawal of the drug. 

Topically, it is used in the form of ointment to relieve the pain of 
boils, abscess, carbuncles and hemorrhoids, either alone or with bella- 
donna: ^ Extracti opii, extracti belladonnas alcoholici, aa gr. xxj ; 
acidi tannici, gr. x ; adipis, oss. M. et Sig. — Apply to piles. In sup- 
pository, it is serviceable both for its local and constitutional effects, in 
strangury, acute cystitis, anal fissure, proctitis, prostatitis, uterine dis- 
orders, as abortion, and to control chordee : ^ Extracti opii, gr. j ; 
extracti belladonnae alcoholici, gr.ss. M. ft. supposit. no. I. As a 
sedative collyrium, in aqueous solution, with lead-water, as an anodyne 
loticm, or as an addition to poultices, it is daily employed. 

Administration. — The ordinary dose of opium for adults as an 
anodyne and hypnotic is gr. ss-ij. Much larger doses are, however, 
called for in many diseases ; and when it is administered for a length 
of time, the dose must be gradually increased. To infants and very 
old persons it is to be given with great caution; children of three years 
may take gr. -h, of six, gr. 2V, and at eight, gr. tV. Some of its disa- 
greeable effects may be obviated by the addition of other remedies ; 
thus, if it constipate, by combining it with aloes, or if there be ano- 
rexia, with capsicum. For the dose of morphine, see morphine sul- 
phate. 

The following are the official preparations of opium : — 

Opii Puivis [Opium Pozvder). — Used in making most of the opium 
preparations. It should contain not less than 13 nor more than 15 per 
cent, of morphine. This, as Dr. Squibb has pointed out, causes a great 
variation in their strength, depending on the percentage of morphine 
in the powdered opium; thus laudanum f§j may contain from gr. 5.44 
to gr. 7.25 of morphine. 

Opium Deodoratum (Deodorized Opium). — Opium freed from nar- 
cotine, etc., by means of ether, and containing 14 per cent, of morphine. 
Dose, gr. ss-ij. 

Pilulae Opii (Pills of Opium). — Each pill contains gr. j. 

Extractum Opii (Extract of Opium). — Dose, gr. y 2 . 

Trochisci Glycyrrhizae et Opii (Troches of Glycyrrhiza and Opium). 
Wistars cough lozenges are very useful to allay irritative laryngeal 



92 MATERIA MEDIC A AND THERAPEUTICS. 

or pkar) igeal cough and hoarseness. Each troche contains gr. so of 
extract of opium. 

Empiastrum Opii (Opium Plaster). — Made by mixing extract of 
opium with Burgundy pitch, lead plaster and water. Useful to allay 
the pain of boils, and as a topical anodyne. 

Purvis Ipecacuanhae et Opii [Powder of Ipecac and Opium). — Dover's 
Powder is a most valuable anodyne diaphoretic, extensively prescribed 
in the early stages of acute diarrhoea, dysentery, acute rheumatism, bron- 
chitis, pneumonia, acute nasal catarrh, etc. Dose, gr. x, containing gr.j 
of opium and ipecac each ; it may be had in compressed tablets; or in 
syrup, gtt. 15-60 for a dose. 

Tinctura Opii {Tincture of Opium). — Laudanum contains 10 per 
cent, of powdered opium. It should be recollected that the opium 
from which these preparations are made contains from 2 to 6 per cent, 
more morphine than that formerly employed. This is the most com- 
monly used of all the official preparations of opium. When long 
kept, particularly if exposed to the air, it becomes thick from evapora- 
tion of the alcohol, and its strength is much increased. Dose, TTLxij, or 
about 25 drops, equivalent to opium gr.j ; for a child under I year, 
gtt. j-ij ; 4 to 6 years, gtt. iij-v. There are 120 drops in f5j- To re- 
lieve the pain of earache the introduction of hot laudanum and olive-oil 
within the external auditory canal is a good remedy ; applied to the 
gum or cavity of a tooth it palliates toothache. Laudanum is much 
used in the form of enema (see enemata), and as an anodyne poultice 
(see poultices). 

Tinctura Ipecacuanhae et Opii (Tincture of Ipecac and Opiuni). — 
Dose, Tftx-xx. 

Tinctura Opii Camphorata (Tincture of Camphorated Opiuni). 
Paregoric Elixir. — Contains opium in diluted alcohol, with benzoic 
acid, oil of anise, glycerin and camphor. Dose, foss, or a tablespoon- 
ful, containing rather less than a grain of opium. A child of 1 month 
may take gtt. viij ; of 1 year, gtt. xv ; of 5 years, gtt. xxv. A favorite 
preparation for children, and particularly serviceable in cholera in- 
fantum and bronchitis. 

Tinctura Opii Deodorati (Tincture of Deodorized Ophtni). — In pre- 
paring it, the narcotine and odorous ingredients of opium are got rid 
of. A valuable preparation. Dose, TTLxij. 

Acetum Opii ( Vinegar of Opium). — Black Drop. — Dose, TTLxij. 

Vinum Opii ( Wine of Opium). — Sydenham' \s Laudanum. — Dose, TTLxij . 

Morphinae Sulphas (Morphine Sulphate). — Morphinae Acetas (Mor- 



NAR CO TICS— LA CTUCARIUM. 93 

pliine Acetate). — Morphinae Hydrochloras (Morphine Hydro chlorate), are 
the official salts of morphine, made by saturating the alkaloid with 
sulphuric, acetic or hydrochloric acids. The sulphate and hydro- 
chlorate occur in the form of snow-white feathery crystals, the acetate 
(which is not very stable) as a white powder. They have a bitter 
taste, mix with alcohol, and are all freely soluble in water (the 
acetate requiring 25 parts, the sulphate 21, and the hydrochlorate 
24), and produce analogous medicinal effects ; the sulphate is most 
employed in this country. The salts of morphine possess the analgesic 
and hypnotic, but not the diaphoretic properties of opium, and are con- 
sidered less apt to produce headache, nausea or constipation. They are 
peculiarly adapted to the hypodermic and endermic methods of applica- 
tion. Dose, gr. i~i, equal to opium gr. j. They may be had in 
granules or pills of any strength. For hypodermic use, the com- 
pressed tablet, or the powder dissolved in water as required, is em- 
ployed, and its efficiency is often promoted by the addition of atropine. 

Trochisci Morphinae et Ipecacuanhae (Troches of Morphine and 
Ipecac). — Each troche contains gr. ifc of morphine sulphate and gr. xV 
of ipecac. 

Pulvis Morphinae Compositus (Compound Powder of Morphine} 
(Tzdly's Powder). — Contains morphine sulphate (1 part), mixed with 
camphor, liquorice and calcium carbonate (of each, 20 parts). 

Codeina (Codeine) is official. It has been found to possess un- 
certain narcotic powers, gr. j having failed to be hypnotic, while 
gr. iv have caused insomnia and slight delirium ; * again, gr. v have 
produced no effect (S. Weir Mitchell). Toxic effects f have been super- 
induced by gr. iij, the symptoms being vomiting, restlessness, thirst, 
convulsive movements, fullness in head, contracted pupils, and dermal 
hyperesthesia. It may be used as an anodyne and hypnotic. It has 
been given with success in gastrodynia, to allay troublesome cough, 
and is of service in diabetes mellitus (gr. y 2y t. d. up to gr. vj, in 24 
hours). 

Administration. — Dose, gr. ss-ij, in water, with elixir of orange, 
or in pills. 

LACTUCARIUM — LETTUCE OPIUM. 

Description and Varieties. — Lactucarium is the concrete 
milk-juice of Lactuca virosa, the garden-lettuce (Nat. Ord. Composite), 

* British Medical Journal, 1874, I, 478. 
■\~Therap. Gaz., Jan. 15, 1894, quoted. , 



94 MATERIA MEDICA AND THERAPEUTICS. 

and is obtained from incisions in the stem of the plant during the 
period of inflorescence. Two varieties are found in the market, 
English and German lactucarium, the latter being inferior. 

Properties and Constituents. — It occurs in small, brownish 
lumps, with an opiate smell. The bitter-principle, termed lactucin, is 
said to possess less hypnotic power than the crude drug. A minute 
quantity of an alkaloid resembling hyoscyamine has been found. 

Effects and Uses. — Lactucarium possesses very feebly the ano- 
dyne and hypnotic qualities of opium. It may be given where opium 
disagrees from idiosyncrasy. 

Administration. — Dose, gr. x ; of the syrup (syrupus lactucarii), 
f 5ij-iv ; of the tincture, {tinctura lactucarii), f 5j-j %• 

PARALDEHYDUM PARALDEHYDE. 

Description and Preparation. — This remedy is a polymeric 
modification of ethyl aldehyde (C 2 H 4 3 ), and is formed by treating it 
with a mineral acid. 

Properties. — It is a colorless liquid, boiling at about 25 5 F., and 
solidifying into fusible crystals at 51 F. It has an odor resembling 
that of chloroform, is more soluble in cold (8.5 parts) than in hot 
water, and has a sp. gr. of .998. 

Aids. — Morphia. 

Physiological Effects. — The action of paraldehyde has been 
studied by Drs. Cervello,* Morselli,f Albertoni,J S. A. Popoff,§ 
Andruzski, || Carl von Noorden,1f Berger, Langreuter,** Dana and 
others. Locally: it is strongly antiseptic and anti-fermentative. 
Alimentary tract: Its taste is acrid and unpleasant; as a rule, no 
gastro-enteric disturbance occurs after its ingestion ; but if the dose 
be large and the medicine administered for a prolonged period, gastric 
catarrh and disordered nutrition may result (Andruzski), though most 
observers have not seen these effects following its prolonged use. 
Secretion : the urine is increased in amount. Prof. PopofT found that 
large intravenous injections destroyed the red corpuscles and pro- 
duced haematuria. Nervous system : all observers agree that it is 

* Archiv. Ital. de Biologie, 1884, p. 1 13. Archiv. pour le Science Med., Vol. VI. 

f Gazz. degli Ospitali, Jan., 1883, N0S - Iv > Vand VI. 

% Riv. di Chim. Med. e Farmaceu tossico e Farmaco., Feb. and Mar. 1883. 

\ Arkhiv. Psykhiatriee, etc., Vol. IV, Fasc. I, 1884, p. I. 

|| Meditz. Obozrenie, Fasc. I, Vol. XXI, 1884, p. 69. 

\ Centralbl. fur Klin. Med., March 22, 1884. 

** Centralbl. fur Klin. Med., loc. cit. Berlin. Klin. Wochensch,]\ine 16, 1884. 



NARCO TICS— PARALDEHYDE. 95 

hypnotic and sedative, lowers reflex activity, and is comparatively free 
from unpleasant after-effects. The action of paraldehyde is exerted on 
the hemispheres, medulla and cord, in the order named (Coudray). 
Small doses cause a temporary increase, followed by depression of 
the excitability of the cerebral cortex, and quiet, tranquil sleep. When 
a large dose is taken the primary stimulation is absent. The pupils 
are unaffected. Paraldehyde depresses, and in toxic doses paralyzes 
the respiratory centre of the medulla. The reflex centres of the cord 
and the peripheral endings of sensory nerves are depressed, causing a 
diminution, and, if a toxic dose has been taken, a subsequent loss of 
sensibility, reflex action, and voluntary motion ; the excitability of 
the motor nerves and of the striated muscles remains unimpaired. 

Circulation : even large doses do not affect the circulation nor the 
arterial tension. If, however, toxic doses be administered, the cardiac 
frequency is at first decreased, but soon increased, the individual beats 
becoming weaker than normal, a gradual fall taking place in the blood- 
pressure, the heart finally stopping in diastole. It is said that the 
cardiac arrest is only due to cessation of the respiratory act, and that 
it may be prevented by resorting to artificial respiration. 

Respiration and temperature : more or less marked slowing of 
respiration always occurs, and if a sufficiently large dose be taken, 
there is final respiratory paralysis of central origin. The temperature 
is slightly lowered. 

Elimination takes place through the kidneys and the lungs, the 
odor of paraldehyde having been detected in the breath twenty-four 
hours after its administration. 

Medicinal Uses. — Paraldehyde is contraindicated in irritable 
states of the throat and stomach by reason of its acridity. It is chiefly 
used as an hypnotic in the insomnia of various mental disorders, or in 
insomnia from prolonged mental work, or where other hypnotics 
have proved insufficient or are contraindicated. Its good effects are 
especially conspicuous where insomnia is not due to pain or to me- 
chanical causes, such as dyspncea or cough. In the insomnia of acute 
or chronic mania, delirium tremens, etc., it is useful by procuring sleep, 
but otherwise exerts no influence upon the disease. 

It has also been used with occasional benefit as an anodyne and 
hypnotic in neuralgic affections (Morselli). 

Cervello found that paraldehyde was a physiological antagonist 
to strychnine, preventing the toxic symptoms of that alkaloid if given 
before their appearance, or causing their subsidence if administered 



96 MATERIA MEDIC A AND THERAPEUTICS. 

after their development, and acting whether used with, before, or after 
strychnine. This action is not reciprocal, as strychnine appears to 
exert little or no influence over paraldehyde-narcosis. 

Administration. — Dose, f5ss-j. It is best given in small amounts 
repeated every hour as required, than in a single large dose (Strahan);* 
more than gtt.lx are rarely required to produce sleep. Paraldehyde 
may be administered in capsule, or emulsified with acacia and syrup of 
almonds, which disguises somewhat its unpleasant taste. It has also 
been exhibited in suppository. 

SULPHONAL. 

Description and Preparation. — This substance (not official), 
discovered by Bauman in 1886, is produced by the reactions ensuing 
between ethyl hydrosulphide, and acetone and sulphuric acid, in 
which diethyl-sulpho-dimethyl-methane (C 5 H 12 4 S 2 ) is formed. 

Properties. — It is obtained in colorless, inodorous, insipid, pris- 
matic crystals, almost insoluble in cold water, but miscible in boiling 
water, 1 to 15, remarkable for its stability, and the resistance it opposes 
to alkalies, acids (except H 2 S0 4 and HN0 3 ) and oxidizing agents. 

Incompatibles. — On account of its insolubility in the ordinary 
menstrua it should be prescribed alone. 

Aids. — Morphia increases its hypnotic effect and may be given 
with it in the same capsule. 

Physiological Effects. — The action and uses of sulphonal have 
been carefully studied by Egasse, f Hogarth, % A. Kast § and Schick, || 
the latter experimenting upon frogs and rabbits by hypodermic injec- 
tion. Egasse finds that unlike paraldehyde and chloral it does not dis- 
turb digestion, alter the blood-pressure, nor affect the respiration of 
dogs, even in toxic cases, though it induced profound sleep. Upon 
canine locomotion a large quantity causes trembling of the gait, the 
movements becoming irregular, the animal finally sinking into deep slum- 
ber. Schick concludes, after a number of experiments by his method, that 
it does not affect the motor-nerve irritability, the sensory nerves or 
cardiac action, beyond a slight acceleration, but that it lowers reflex 
activity, quickens the pulse slightly, raises the arterial tension, and 
— 

* Lancet, London, Jan. 1885. 

| Bull. Gen. de Therap., 1889, p. 210. 

% Lancet, London, Oct. 12, 1889. 

$ Arch, fur exper. Pathol, u. Pharm., 1 893, p. 69. 

|| Journ. of Nervous and Mental Dis., 1889, p. 32. 



NAR CO TICS— CHL ORALAMIDE. 97 

depresses respiration, the latter uninfluenced by section of the vagi. 
Sulphonal is eliminated by the kidneys, as an organic sulphide, not yet 
isolated, without altering the quantity of nitrogenous matters excreted 
in the urine. 

Toxicology. — Toxic doses cause painful convulsions, muscular 
resolution, stupor and death. An autopsy made upon animals killed 
by sulphonal showed violent congestion of the kidney-medullary sub- 
stance, as well as the same condition about the cerebral and spinal 
meninges. A fatal instance * is reported of poisoning by sulphonal, 
which, however, must be considered as most unusual considering the 
quantity swallowed, of a woman who succumbed to two doses of gr. 
xv each, taken at intervals of i J^ hours. Profound sleep ensued, fol- 
lowed by failure of respiration, and death in 40 hours. A casef in 
which gr. 240 killed a male, age not given, is recorded, the chief symp- 
tom being likewise deep sleep. Nitro-glycerine, hypodermically, was 
used as an antidote. 

Medicinal Uses. — The use of this medicament is limited to the 
production of sleep, and to calm excitement as in simple insomnia, acute 
mania, hysteria, dementia, alcoholism, neurasthenia and melancholia. Its 
action is usually slow, at times wanting. It possesses no analgesic 
power. Such sequelae, after awaking, as fatigue and continued som- 
nolence have been noted. It is much used in asylum practice. 

Administration. — By reason of its insolubility, it may be given 
in capsule, pills, or tablets, previously well pulverized, or in hot whiskey, 
and should be taken after a meal, about 2 hours prior to the required 
sleep. Dose for infants, gr. iij-vi; adults, gr. xv-xxx. For an adult 
the maximum quantity in 24 hours is 5iss. 

CHLORALAMIDE. 

Preparation. — This new hypnotic (not official), introduced re- 
cently by Von Mering, is chemically chloral formadate, consisting of 
chloral anhydride, 2, and formamide 1 part. 

Properties. — It occurs in lustrous, colorless crystals, slowly sol- 
uble in about 20 parts of water, and freely miscible in alcohol. 

Incompatibles. — Is decomposed by the caustic alkalies, slowly by 
the alkaline carbonates, and by water above 140 F. 

Aids. — By potassium or sodium bromide in solution. 

Physiological Effects. — Locally it is non -irritant, even when 

* Med News, Aug 10, 1 889. 

f Boston Med. and Surg, Journ , 1893 



98 MATERIA MEDICA AND THERAPEUTICS. 

applied to the conjunctiva Its taste is mildly bitter. Upon the diges- 
tive and renal apparatus it is practically without influence. It acts 
chiefly on the cerebral cortex, causing natural sleep and muscular 
relaxation in from I to 3 hours after ingestion, and lasting between 6 
and 10 hours. Such sequelae as lassitude and somnolency have been 
reported after its exhibition, but they are exceptional. The influence 
of chloralamide upon the circulation is feeble and not injurious, and it 
may be given safely in cardiac maladies. In the blood it is stated to 
split up into chloral and formamide. Upon the respiratory apparatus 
in moderate amounts, it is powerfully stimulant. 

Medicinal Uses. — Chloralamide * is employed chiefly as a sleep- 
producing remedy,. the best results being obtained by its exhibition in 
cases of insomnia, uncomplicated with pain or much excitement. 
When the sleeplessness is due to nervousness, hysteria, neurasthenia, 
old age, alcoholism, cardiac and bronchial asthma, it is particularly 
serviceable. It is less efficacious in cases of neuralgia, severe headache, 
and maniacal excitement. When taken habitually, increase of the daily 
dose is not required. 

Administration. — Dose, gr. 15 to 45; pro die 5jss; it may be 
dispensed in powder, capsule or solution. A good formula is: 
& Chloralamide, 3ij ; spt. frumenti, f §i ; — ft. sol. et adde syrup, rubi 
idsei, f Si. M. S. A tablespoonful ; to be repeated in an hour if required. 
Chloralamide should be given 1 y 2 hours before bedtime. Hypodermi- 
cally TTLxv of a 4 per cent, solution will produce sleep. 

BELLADONNA DEADLY NIGHTSHADE. 

Belladonnse Folia, Belladonna Leaves ; Belladonnas Radix, Belladonna Root. 

Description, Habitat and Official Portion. — Atropa Bella- 
donna (Nat. Ord., Solanaceae), is a European perennial plant, with 
herbaceous, branched downy stems, about three or four feet high, 
large ovate leaves of a dull-green color, and drooping, bell-shaped 
purple flowers. The whole plant possesses narcotic properties, but 
the leaves and root only are official. 

Properties. — The root should be obtained from plants more 
than two years old ; the dried root is long, round, from one-half to 
two inches in thickness, branched, of a reddish-brown color, and of 
little odor. 

*See Helbing's Mod. Mat Med. 1894. H. C. Wood's and D. Cerna's Laboratory Experi- 
ments, Univ. of Penn., Feb., 1891. Brit. Med. Jour., Nov. 2, 1SS9. Lancet, Oct. 26, 
.1889, and Feb. 15, 1890. 



NAR CO TICS— BELLADONNA. 



99 



Chemical Constituents and Tests. — The active alkaloid of bel- 
ladonna is atropine, which exists combined with malic acid, and is 
found in all parts of the plant. It is official, and is prepared from the 
root by exhaustion with alcohol, afterward adding sulphuric acid, 
precipitating with potassa, dissolving the atropine in chloroform, and 
then evaporating the chloroform. Atropina [Atropine] (C 17 H 23 N0 3 ) 
occurs in the form of yellowish-white, silky, prismatic crystals, without 
smell, but of a bitter, acrid taste, soluble in alcohol, freely in ether, 
still more so in chloroform, but only slightly soluble in water. The 
best test is bromine in hydrobromic acid, which produces a yellow 
amorphous precipitate, soon becoming crystalline, and will detect at 
least gr. 2zhs (Wormley) ; auric chloride gives with atropine solution a 

Fig. 6. 




ATROPA BELLADONNA: A, ROOT ; B, LEAVES. 

yellow amorphous precipitate ; the physiological test should also be ap- 
plied, viz., by dilating the pupil of a rabbit or a cat by local application 
to the eye. It is a most energetic poison, producing analogous effects 
to those of belladonna, but much more powerful. Another alkaloid 
termed belladonnine has been isolated, which, according to Laden- 
burg, is isomeric with hyoscyamine and atropine. It has, however, 
a lower fusing point, and yields a different salt with gold chloride. 

Incompatibles. — Prolonged contact with the caustic alkalies 
decomposes atropine and its salts, ammonia being liberated. The 
alkaloids atropine, hyoscyamine and daturine, alone or combined, 
are incompatible with tannin and vegetable infusions containing the 
same, an insoluble tannate being formed. 



100 MATERIA MEDICA AND THERAPEUTICS. 

Aids. — Stramonium, hyoscyamus and duboisia possess analogous 
effects. 

Physiological Effects. — The authorities consulted for this article 
are Meuriot,* Fraser,f Bezold and Bloebaum, J Lemaitre, § and 
Bonders. || The physiological properties of belladonna depend on the 
presence of the alkaloid atropine. Belladonna or atropine applied 
locally diminishes sensation and can be absorbed through the unbroken 
skin, thus producing systemic effects. Belladonna, as does atropia 
solution applied to the conjunctiva, brought in contact with the tem- 
poral region, causes dilatation of the pupil, and accompanying its my- 
driatic action there is paralysis of accommodation and a diminished 
intra-ocular pressure. When dropped into the eye, contact with the 
iris being necessary, it brings about dilatation probably by paralysis of 
the end-organs of the third nerve and stimulation of the sympathetic. 
In the mouth it has a feebly sweetish taste. Secretion : belladonna 
checks the salivary secretion by paralyzing the peripheral endings of 
the chorda tympani nerve in the submaxillary gland, hence the dry- 
ness of the mouth and throat experienced after its use. Its effect on 
the urinary secretion is doubtful, but it unquestionably augments the 
solids ; it effectually checks the perspiration by a local paralyzing 
action on the peripheral nerve-end organs ; upon the intestinal glands 
Its action is uncertain. No matter how used, it diminishes the secre- 
tion of the mammary glands. Atropine restrains the biliary flow. 
Nervous system : in small doses it is a cerebral exhilarant, tending in 
larger doses to produce hallucinations and delirium. The exact quan- 
tity required to induce these effects cannot be stated, as individual 
susceptibility differs. Belladonna dilates the pupil, in whatever way 
exhibited ; internally it is thought to cause pupillary dilatation by a 
local action. In large doses the excitability of the motor and sensory 
nerves is impaired by this drug; but the contractility of striated 
muscles remains unaltered. It tetanizes the cord, and heightens its 
reflex function (Ringer, nth ed., p. 401). Circulation : it increases the 
heart's movements by stimulating the cardiac ganglia of the sympa- 
thetic and paralyzing the peripheral ends of the pneumogastrics, and 
as it excites the vaso-motor centre, an increase in blood-pressure also 

*" De la Method. Phys. de la Belladonne," 1868 ; an elaborate monograph. 

| Trans. Roy. Soc. Edin., 1 869, p. 449. 

% Wiirzburger Physiol. (Jntersuchungen, 1867, p. 3. 

\ Arch. Gen. de Med. } vi, 6 ser., p. 173. 

||" Accom. and Refrac. of the Eye," 1864, p. 558. 



NAR CO TICS— BELLA D ONNA. 101 

takes place. Respiration : this is quickened by stimulation of the res- 
piratory centre. Involuntary muscles : it induces intestinal per- 
istalsis. Temperature : in small doses it elevates the body-heat ; in 
large, reduces it. Atropine is eliminated by the kidneys. In larger 
doses it causes dilatation of the pupils, loss of vision, giddiness, con- 
striction of the throat, difficulty of deglutition and articulation, in- 
creased heart-action, quickened respiration, elevation of temperature, 
nausea, with occasional vomiting and purging, and sometimes a red 
eruption. 

Toxicology. — When excessive doses are taken the temperature 
of the body falls, the muscular system is relaxed, sensation is im- 
paired, the pulse fails, and maniacal delirium sets in, followed by coma, 
syncope and death, often preceded by convulsions. The fatal dose of 
atropine cannot be precisely stated, as death has followed gr. T V per 
orem,* while recovery took place after swallowing gr. jss, and gr. xxx- 
xxxv of the extract of belladonna taken by a child in mistake for 
liquorice.f Even the prolonged application (twelve days) of a bella- 
donna plaster, % 5x3, has produced toxic symptoms. Post-mortem 
examination shows that the action of the poison is not confined to the 
cerebro-spinal system, there being evident inflammation of the digestive 
organs. 

Antidotes. — Poisoning by belladonna is treated by evacuation 
of the stomach, cathartics, and, if coma occur, by the electro-magnetic 
battery. Pilocarpine and physostigma are the physiological antidotes, 
or hypodermic injections of morphine may be administered for their 
stimulating effect upon the respiratory centres {see opium). As atro- 
pine and its salt is decomposed and rendered inert by prolonged con- 
tact with the caustic alkalies, the solutions of potassa and soda are 
recommended as antidotes for belladonna ; with tannin an insoluble 
tannate is formed. 

Medicinal Uses. — Belladonna is one of our most highly esteemed 
anodyne and antispasmodic remedies. It is destitute of hypnotic effect, 
and, on the contrary, has a tendency to occasion wakefulness. In the 
treatment of neuralgia (extract, gr.ss) it ranks at the head of the narcot- 
ics, and is extensively employed both alone and with quinine sulphate 
(gr.x) and general tonic treatment. In myalgia, lumbago, and sciatica, 
the subcutaneous injection of atropine gives speedy relief and may be 

* Jour, de Chimie Med., i860, p. 529. Roux. 
f Cincinnati Lancet and Observer, 1 861, p. 609. 
% Edinburgh Hosp. Reports, II, p. 639, 1894.; 



102 MATERIA MEDICA AND THERAPEUTICS. 

advantageously combined with morphine. It should be given until 
dryness of the throat, dilatation of the pupil, or some disorder of vision 
is produced. Its powers of allaying spasm have been found very 
efficacious in the treatment of whooping-cough, in which atropine sul- 
phate, gr. T7o, may be given in water once daily to children of from 
one to four years of age, diminished or increased according to the 
severity of the paroxysms and the effect produced. In asthma, a 
nightly dose at bedtime large enough to produce constitutional effects 
often prevents the paroxysm and in some cases, cures the disease. In 
colica pictonum (see lead) and in laryngismus stridulus, belladonna 
ranks among the best antispasmodic remedies. In the latter disease, 
combined with the bromides, and, in the absence of laryngitis, repeated 
sponging of the neck with cold water, it is most efficacious. Pre- 
scribed with ergot it is often serviceable in exophthalmic goitre. 

Combined with opium in suppository, it is used for the relief of 
dysmenorrhea, but is only palliative, as the treatment of this symptom 
depends upon its cause. A belladonna and opium suppository will, in 
a measure, relieve chordee. As a stimulant to the circulatory system, 
belladonna may be used wherever syncope is threatened from cardiac 
failure. By its influence in relieving irritability of the bladder, it is 
probably the best remedy for the nocturnal i?icontine7ice of urine of 
children, for which purpose gtt. iij-v of the tincture may be cautiously 
given three or four times a day, and the child waked at midnight to 
pass water. 

In habitual constipation due to atony of the muscular fibre, after 
a dose of castor oil, the following is efficacious to reestablish peri- 
stalsis : R Extracti belladonnae, gr. to ; aloin. gr. h ; extracti nucis 
vomicae, gr.^. M. ft. pil. I. S. one pill after meals t. d. for some time. 
Hypodermic injections of atropine, gr. sV^o, are useful in checking the 
night-sweats of phthisis, and may be advantageously combined with 
minute doses of morphine, to relieve the cough ; the following also is 
a good combination : R Atropinae sulphatis, gr. to ; strychninae sul- 
phatis, gr. \\ codeinae, gr. x; aquae, foijss. M. S. Teaspoonful morn- 
ing and evening. Hypodermics of atropine, well combined with 
morphia, are often serviceable in spinal irritation and torticollis, and 
should be injected near the seat of pain. 

And, lastly, from its anhydrotic action, atropine is useful in vier- 
curialismus. 

As a topical remedy, belladonna is employed as an anodyne to 
a blistered surface, carbmicle, boil, and abscess, and also to relieve 



NARCO TICS— BELLADONNA. 103 

rigidity of the os uteri in labor, and in spasmodic urethral stricture, the 
application of the ointment to the constriction by a bougie is effica- 
cious. A plaster, or ointment (ext. of belladonna 5i, glycerin fgj, 
applied on lint) or solution of atropine may be applied to the breasts 
of nursing women as a galactafuge ; while the plaster alone to the 
back, often relieves lumbago and sacralgia. The liniment may be used 
to relieve rheumatism, muscular or gonorrheal, neuralgia and other 
local pains, and is advantageously combined with fluid extract of aco- 
nite as a topical remedy in severe neuralgia. A suppository (gr. ss-j 
of the extract) is often sufficient for the relief of strangury, irritability 
of the bladder, to allay the hyperesthesia about the prostate and deep 
urethra in spermatorrhoea : in acute cystitis, this form combined with 
a milk diet and rest in the recumbent posture, at the same time keep- 
ing the urine alkaline by liquor potassae, is one of the best plans of 
treatment. Belladonna ointment applied to the scrotum on lint relieves 
the pain of orchitis. Hyperidrosis of certain parts, as the axilla, palms 
and toes, may be checked by an application of tincture of belladonna. 

Atropine in Ophthalmic Practice. — Harlan * gives the follow- 
ing practical points in regard to the use of atropine in ophthalmic 
practice. A four grain to the ounce solution produces full mydriatic 
effects. One drop of the solution causes dilatation of the pupil, which 
begins in less than fifteen minutes, reaching the maximum in about 
twenty-five minutes. Much weaker solutions are instilled for an oph- 
thalmic examination. The mydriasis of a gr. ^ solution lasts three or 
four days ; that of a gr. iv, nearly two weeks. Homatropine and 
cocaine are taking the place of atropine, as they are less inconvenient 
to the patient. According to Donders, atropine acts more slowly upon 
accommodation than on the pupil. A gr. iv solution does not completely 
paralyze the former until the lapse of one hour and a half. Accom- 
modation returns in about eleven days. Atropine is contraindicated 
if there be a tendency to glaucoma, and it occasionally induces con- 
junctivitis. Ophthalmic disks of atropine sulphate gr. 21V0 to aio may 
be had. 

Ocular Therapy. — The use of atropine in eye-diseases is of the 
greatest importance; solutions of the sulphate (gr. i-ij to foss of water), 
may be dropped into the conjunctival sac, to relieve pain and photopho- 
bia, to determine the refraction of the eye from its influence on accom- 
modation, in the diagnosis of suspected cataract, in operations for cat- 

* Handbook of Local Therapeutics, p. 128, 1893, 



104 MATERIA MEDICA AND THERAPEUTICS. 

aract, prolapsus iridis, and ulcers of the cornea. To prevent iritis and 
posterior synechia it is indicated in keratitis. The instillation of 
atropine solution is indicated in ophthalmia if iritic and corneal com- 
plications threaten. A good treatment for iritis is the instillation of 
atropine solution until the pupil is widely and evenly dilated, at the 
same time giving mercury internally, and continuing all until the 
danger of synechia is passed. It should be recollected that the local 
application of belladonna, or its alkaloid, may produce the constitu- 
tional effects of the drug. 

Homatropine (not official). — This is made from tropine amyg- 
dalate and dilute hydrochloric acid, atropine having been split into 
tropine and tropic acid. It is similar in its effects to atropine, though 
one-fourth weaker. Applied to the pupil, it quickly brings about 
wide dilatation, which lasts from two to four days, is unirritating, and 
hence is an acquisition in ocular therapeutics, as iritis and prolapsus 
iridis. For ophthalmoscopic purposes, the strength is gr.j to 5J ; or 
disks can be had from gr. tsws to shjs ; as an internal agent, gr. 200-T00. 
The hydrobromate is the salt in use. 

Administration. — The dose of the powder of the root or leaves 
of belladonna is gr. j, to be repeated and increased till dryness of the 
throat, dilatation of the pupil, or dimness of vision is produced. 
The tincture (tinctura belladonnce folioruni) (25 parts of the leaves to 
diluted alcohol q. s. to make 100 parts of tincture — dose, gtt. 15 to 30), 
and the alcoholic extract of bellado7ina leaves (extr actum belladonnce 
foliorum alcoholicum) are official, dose gr. J^ ; in suppository gr. y 2 . 
Of the fluid extract of belladonna root (extractum belladc?ino3 radicis 
fluidum) the dose is ITLj-v. For external use, a plaster {emplastrum 
belladonnce), an ointment (unguentum belladonnce, a useful anodyne 
application in adenitis, herpes zoster, chilblain, and with opium to Jicem- 
orrhoids), and a liniment {linimentum belladonna?, containing fluid ex- 
tract 95 per cent., and camphor 5 per cent.) are employed. 

Atropina {Atropine), or its official salt Atropine Sulphas {Atro- 
pine Sulphate), is generally employed medicinally instead of belladonna, 
as it represents the activity of the drug, because of the smallness of 
the dose required, and its fitness for hypodermic use. The sulphate, 
which is obtained by mixing the alkaloid with water, and gradually 
adding diluted sulphuric acid until the alkaloid is dissolved and the 
solution neutral, when the salt is obtained by evaporation, consists of 
a white, slightly crystalline powder, very soluble in water and alcohol, 
but insoluble in ether. As a medicinal agent, the salt is preferable 



NARCO TICS— BELLADONNA. 105 

because more soluble. Dose, gr. rio-io, for hypodermic use, gr. 

STRAMONIUM— THORN-APPLE OR JAMESTOWN WEED. 
Stramonii Folia, Stramonium Leaves ; Stramonii Semen, Stramonium Seed. 

Description, Habitat and Official Portion. — Datura Stra- 
monium, or Thorn-Apple {Nat. Ord. Solanaceae), is an annual indi- 
genous plant, which grows very abundantly in waste grounds in all 
parts of the world. It has a forked, branching stem, from three to six 
feet high, ovate, toothed leaves, large funnel-shaped white or purplish 
flowers, which appear in midsummer, and ovate capsules, filled with 

Fig. 7. 




DATURA STRAMONIUM: A, SEED. 



numerous kidney-shaped, brownish-black seeds. The odor of the 
plant is strong and disagreeable, and its taste bitter and nauseous. It 
loses these properties very much when dried ; but the process does not 
appear to weaken its narcotic qualities. The leaves and seeds are 
official ; but the seeds are most powerful from containing most daturine. 

Chemical Constituents. — The active principle of Stramonium 
is an alkaloid formerly termed daturine, but which appears to consist 
of a mixture of atropine and hyoscyamine.* It exists in the seed com- 
bined with malic acid. 

Incompatibles. — See belladonna. 

Aids. — Belladonna, hyoscyamus and duboisia. 

* Berichte d. chem. Ges. 13, p. 909, Ladenburg. 



106 MATERIA MEDICA AND THERAPEUTICS. 

Physiological Effects. — The action of stramonium is closely 
allied to, but weaker than that of belladonna. It is eliminated * by 
the urine. 

Toxicology. — From its common occurrence in every part of the 
country, cases of poisoning from this weed are very frequent, particu- 
larly with children, who are fond of swallowing the seeds. A case is 
reported by Calkinsf of a boy aged four years, who swallowed a 
tablespoonful of the seeds, but, as he soon vomited them, no ill effects 
resulted. The treatment laid down for the relief of poisoning from 
belladonna is applicable to these cases. 

Medicinal Uses. — It is sometimes prescribed internally in neu- 
ralgia ; and in asthma, gr. xxv of the dried leaves are smoked with 
great relief in cigarettes or pipes, the smoke being drawn into the 
lungs and the inhalation frequently repeated. Topically ', daturine is 
occasionally used by oculists to dilate the pupils when other mydri- 
atics cannot be employed. Stramonium is an excellent anodyne appli- 
cation in the form of cataplasm and ointment, to irritable ulcers, bed- 
sores and hcemorrhoids ; as 3^ Ext. stramonii, acidi gallici, pulv. opii, aa. 
5ss; ungt. aq. rosae q.s. Si., M. S. ft. ung't. 

Administration. — The dose of the powdered leaves is gr. ij ; of 
the seeds, gr. j, to be repeated and gradually increased till effects are 
produced. Dose of the extract of the seed (extractum stramonii seminis), 
gr. y 2 , may be given in capsules. The fluid extract {extractum stra- 
monii fluidum seminis), dose Tfljj-v; the tincture (tinctura stramonii 
seminis), (10 per cent, of the seed, dose TTLv-xxx) ; and the ointment 
[u7iguentum stramonii), made by mixing the extract with benzoinated 
lard, are also official. 

HYOSCYAMUS— HENBANE. 
Hyoscyami Folia, Hyoscyamus Leaves. 

Description, Habitat and Official Portion. — Hyoscyamus 
niger (Nat. Ord. Solanaceae), is a native of Europe, and is naturalized 
in the northern parts of the United States. It grows to the height of 
about two feet, with large sinuated, pale-green leaves, and flowers of a 
straw-yellow color. The whole plant has narcotic properties ; but the 
leaves and flowering tops only are official. They should be gath- 
ered from plants of the second year's growth when in flower. 

* Arch, de Physiologie Norm, et Pathol., t. iii, 1 870, 215. Oulmont et Laurent; De 
l'Hyoscine et de la Daturine. 

■\Am. Med. Monthly, 1856, p. 220. 



NAR CO TICS— BELLA D ONNA. 



107 



Chemical Constituents. — The active properties of the plant 
depend upon two alkaloids, one crystallizable, termed hyoscy amine 
(C 17 H 23 N0 3 ), isomeric with atropine ; the other an amorphous, brown 
liquid, to which Ladenburg * has given the name of hyoscine, and 
which, though isomeric with hyoscyamine, differs from it very mate- 
rially. Hyoscyamine can be split into tropic acid and tropine, hyos- 
cine into tropic acid and pseudotropine, and both alkaloids unite with 
acids to form salts. 

Incompatibles. — See belladonna. 

Aids. — Belladonna, stramonium, and duboisia. 

Physiological Effects. — The effects of henbane on the system 

Fig. 8. 




HYOSCYAMUS NIGER. 



much resemble those of belladonna. They differ from those of opium 
in their comparatively/"^/^ 7 hypnotic effect, and in their relaxing influ- 
ence on the bowels. In large doses it causes dilatation of the pupil, 
delirium, loss of vision, and, generally, sleep. Hyoscyamine, when 



*Deutsch Chemisch. Gesellschaft, 1 880-8] 



10$ MATERIA MEDICA AND THERAPEUTICS. 

pure, is identical in its action with atropine, and recent researches have 
shown that hyoscinc is the hypnotic principle of henbane, and that it is 
antagonized physiologically by pilocarpine (A. Sohrt). They are both 
eliminated by the kidneys. * 

Toxicology. — Dr. White f describes the case of a woman who 
took fSxj of the tincture by mistake for black draught; she became 
immediately giddy, then delirious, with much dryness of the throat, 
but eventually recovered. In cases of poisoning, the same general 
treatment is to be pursued as for belladonna, from which it cannot 
be distinguished. According to Gnauck % morphine is the best 
antidote. 

Medicinal Uses. — Henbane may be used remedially in the same 
diseases as belladonna and stramonium, than which it is, however, less 
active. The extract is frequently added to purgative pills in constipa- 
tion, to increase their efficiency and prevent griping. The tincture is 
occasionally of service as a sedative to the bladder in acute cystitis. 
Topically, hyoscyamus is employed in the form of cataplasm or 
fomentation to painful swellings and ulcers, and hyoscyamine sulphate 
may be used to dilate the pupil, in the same manner as belladonna. 

Administration. — Dose of the powder, gr. v-x ; tincture (tinc- 
tura hyoscyami), dose, f5j. An extract (extr actum hyoscya7ni), (a prepa- 
ration of uncertain strength, dose gr. ij, increased until some effect is 
produced, or it may be had in form of a tablet), and a fluid extract 
(extractum hyoscyami fluidum), dose, gtt. x-xx, are also official. 

Hyoscyaminae Sulphas (Hyoscyamine Sulphate) [(C^H^NCyHgSOJ] 
occurs in the form of small, yellowish-white scales or crystals, or a 
yellowish-white powder, deliquescent on exposure to the air, without 
smell, but possessing an acrid, bitter taste. It is very soluble in water 
and alcohol. Hyoscyamine is useful in chorea and various forms of 
tremor, || in the dose of gr. sh hypodermically. It is highly recom- 
mended by Brown,§ and confirmed by Lermoine,1[ to quiet the violence 
of and produce tranquil sleep without disagreeable sequelae in acute 



* Arch, fur experimentelle Pathol, und Pharmacol., Vol. XXII. R. Robert und A. 
Sohrt; Arch, de Physiologie Norm, et Pathologique, t iii, 1870, p. 215. De l'Hyosciamine 
et de la daturine par Oulmont et Laurent. 

f Lancet, July, 1873, p. 8. 

% Arch, de Neurologie, July, 1883. 

|| Med. News, Jan.., 1886 Da Costa. 

I Brit. Med. Jour., November 25th, 1882. 

\ Congres. International de Medecine Mentale, 1 889. 



NARCOTICS— DUBOISIA. 109 

mania, though without curative effect. The dose has been variously 
stated by different authors, due, evidently, to the variable purity of the 
drug ; as, however, gr. iV of the pure alkaloid has produced violent 
poisoning,* it is better to begin with gr. rh-u, and gradually increase the 
dose until some effect is produced. 

Hyoscyaminae Hydrobromas [Hyoscyamine Hydrobromate), (C^H^ 
N0 3 HBr), is a yellowish-white resin-like mass, of a tobacco-like odor, 
particularly when damp, a bitter, nauseous taste, and freely soluble 
in water. Dose, gr. sis. 

Hyoscine Hydrochlorate (not official) is freely soluble in water, 
and resembles atropine physiologically, but produces a more decided 
hypnotic action and less delirium. Its use is followed by headache and 
malaise, and Gnauck states that it slows the pulse decidedly. It is 
said not to cause dryness of the throat. Topically, gr.ss to water f5j, 
it widely dilates the pupil, though, in this respect, it is less persistent 
than atropine ; it is employed as a mydriatic in iritis. It has been 
administered in whooping-cough and asthma, and Mitchell Bruce f ad- 
vises it in mania and insomnia, to relieve the delirium and restlessness. 
G. Thompson, % Medical Superintendent, Bristol Asylum, has used it 
successfully, gr. 200, repeated, to allay excitement and produce sleep 
in acute and recurrent mania; but more experience with it is required 
in order to determine its range of therapeutical uses. Dose, gr. -h\ 
hypodermically, gr. tIo, both to be cautiously used at first. 

Hyoscinee Hydrobromas (Hyoscine Hydrobromate), (C 17 H 21 N0 4 HBr 
-f3H 2 0), occurs in colorless, rhombic crystals, odorless, and of slightly 
bitter taste, freely soluble in water. Dose, gr. 3^0-rV. 

DUBOISIA — DUBOISIA FOLIA. 

Description and Habitat. — The leaves of the Duboisia myopo- 
roides (not official) {Nat. Ord. Solanaceae), a tree-like shrub of Aus- 
tralia. They are three to four inches long and one inch broad, entire, 
smooth, and lanceolate. 

Chemical Constituent. — An alkaloid, duboisine (C^H^NOg), the 
salts of which are readily soluble in water, has been isolated, isomeric 
with atropine and resembling it in action. 

Effects and Uses. — Duboisine, internally, produces almost simi- 



* Lancet, 1 879, I, 474. 

f Practitioner, November, 1 886, p. 321. 

% Lancet, February 4th, 1888. 



110 MATERIA MEDICA AND THERAPEUTICS. 

lar effects to those of atropine, except that the mental excitement which 
it causes is followed by stupor. Its effect is best seen on the pupil, 
which it dilates, no matter how exhibited. It differs from atropine in 
causing more rapid dilatation paralysis of accommodation, (both of 
which are more fugitive), and in being less irritating. Its physiological 
action is antagonized by opium and physostigma. The use of duboisine 
is confined to ocular therapeutics, as in iritis, and for the purpose of 
ophthalmoscopic examination. 

Administration. — For ophthalmic purposes gr. ij-iv may be dis- 
solved in water, foj, or it may be had in disks, gr. Woo to toW ; inter- 
nally, gr. j^* 

The Mydriatic Alkaloids of the Solanaceae, just described, all 
of which act locally, will be here reconsidered, in order to make the 
statements relating to them the more easily understood ; they are atro- 
pine, hyoscy 'amine , hyoscine and duboisine. It is now generally admitted 
that they are isomeric,f having the formula C 17 H 23 N0 3 , and, except 
hyoscine, are all clearly allied in physiological action. According to 
Prof. Wormley, atropine, hyoscyamine and duboisine respond similarly 
to the bromine and Vitali's tests. Hyoscine, found only in hyoscya- 
mus niger, is distinguished by possessing an hypnotic action, and in 
being an amorphous, brown liquid. Belladonnine is also an isomer of 
these alkaloids; but its effects have not yet been investigated. All 
possess basic properties, and, with acids, unite to form salts readily 
soluble in water; and, lastly, atropine, hyoscyamine, duboisine and 
hyoscine, form, with gold, salts that have different fusing temperatures, 
which, in a measure, seem to distinguish them physically. 

It is owing chiefly to the investigations of Ladenburg that the 
chemical relations of these interesting principles have been elucidated. 

The mydriatics are employed chiefly to dilate the pupil for oph- 
thalmic examination, as in the diagnosis of cataract, to prevent the iritic 
adhesions of iritis, and prolapsus iridis in perforating ulcer of the 
cornea, and to paralyze the accommodation in testing for astigmatism. 

The Myotic Alkaloids. — These are escrine, pilocarpine, nicotine 
and muscarine, the alkaloid of the Amanita Muscara, or fly-fungus. 
They differ from their congeners in not being isomeric, and belong, 
except nicotine, to different botanical orders. Their action is a local 
one. The myotics, which have a lesser range of utility than the dilators, 
are employed to contract the pupil in photophobia, to counteract the 

*On Ditboisia, Norris, Ringer, Seely, Wecker and Bancroft. 
| Mod. Mat. Medica, Helbing, 1894. 



NARCOTICS- DUBOISIA. 



Ill 



effects of the mydriatics, and alternately with them, to break up adhe- 
sions of the iris. 

CANNABIS INDICA — INDIAN CANNABIS — (FEMALE PLANT). 

Description, Habitat and Official Portion. — Cannabis sativa 
or Indian Hemp {Nat. Ord. Urticaceae), a native of Persia, is the 
flowering tops of the female plant grown in the East Indies. By the 
U. S. P. they are described as " branching, compressed, brittle, about 
5 cm. or more, long with a few digitate leaves, having linear-lanceolate 
leavelets * * * * each containing two small pistillate flowers, some- 
times with the nearly ripe fruit, the whole more or less agglutinated 
with a resinous exudation." The odor of this mass is narcotic, the 
color brown. 

Gunjah is the dried compressed female flowers ; churrus is an 

Fig. io. 



Fig. 9. 




CANNABIS SATIVA. 
(Female Flower.) 




CANNABIS SATIVA. 
(Female Plant ) 



impure resinous exudation, while bhang consists of the broken stalks 
and leaves made up with fruits ; it is known as hashish. 



112 MATERIA MEDICA AND THERAPEUTICS. 

Chemical Constituents. — The chemistry of hemp is unsettled. 
The resin, which is the active principle (Egasse),* has received the 
name of cannabin. Cannabin is described by Helbingf as a brown, 
syrupy alkaloid, and cannabinone, a balsamic resinous body — both 
hypnotics. A volatile oil has been isolated. According to Jahns, % 
the only alkaloid existing in C. Indica is choline, and the principles 
termed cannabinine and tetanocannabine are simply impure choline. 

Aids. — Liquors, wines, cocaine and ether enhance its cerebral 
effects. 

Physiological Effects. — Indian hemp is without local action. The 
taste of the tops is slightly acrid ; upon the stomach the drug produces 
a sedative effect. Nervous system : in medicinal doses it exerts a 
peculiar exhilarating effect upon the brain, the mental excitement 
induced by it being of an agreeable kind, and in this condition ideas 
flow readily, and conception of time is lost. Not infrequently the 
delirium and cerebral excitement induced by hemp causes the individual, 
particularly the Hindoostanis, to do deeds of violence, but it does not 
act upon all alike. A prominent symptom after a full dose is a sense 
of weight about the extremities, accompanied by a loss of muscular 
power, and often a cataleptic state ; there is also cutaneous anaesthesia. 
Sleep follows the intoxicating effects of hemp, and the individual on 
awakening is unconscious of what has happened, but suffers from 
depression. It has no action upon respiration, circulation or the 
secretions, but is said to increase the appetite, and aphrodisiac proper- 
ties have been attributed to it. It is unknown how it is eliminated. 
Though lethal doses of hemp have produced alarming symptoms, there 
are no recorded fatal cases. 

Medicinal Uses. — Indian hemp is not much used nowadays 
except in asylum practice. It has, however, been employed with suc- 
cess as a cerebral stimulant in melancholia,^ and mania ; to relieve the 
pain of dysmenorrhea, especially when dependent on uterine fibroids, 
and for this end the extract (gr. y£) or tincture (TTt v) may be admin- 
istered ; and occasionally as an anodyne in neuralgia t and pruritus. By 
some (Seguin) its prolonged use is considered the most satisfactory 
remedy in migraine. See § gives the extract, gr. ^ t. d., as a gastric 
sedative, in painful dyspepsia with heartburn. 

* Bull. Gen. de Therap., 1890, t. 118. 
\ Mod. Mat. Med., p. 134; 1892. 
\ Arch, der Pharm., 1 887, p. 479. 
|| Brit. Med. J., July 4, 1 891. 
\ Lancet, Sept. 20, 1890. 



NARCO TICS—HUMUL US. 



113 



Administration. — Dose, gr. ss-ij or more. A tincture (tinctura 
cannabis Indices) (15 per cent.), dose Tftv-xxx, and a flidd extract 
{extr actum cannabis Indices fluiduni) are official; dose, Ttlj-xv ; and an 
extract {extr actum cannabis Indices), dose, gr. J^. As various samples 
of cannabis differ much in strength, it is better, when first using a new 
one to begin with the minimum dose, to avoid unpleasant effects. 

HUMULUS — HOPS. 

Description and Habitat. — Hops are the strobiles of Humulus 
Lupulus or Hop-vine (Nat. Ord. Urticaceae), a climbing vine, indi- 
genous in Europe, and probably also in North America, with serrated, 
rough leaves and greenish-yellow flowers. 

Preparation and Official Portion. — The medicinal portion is 

Fig. 11. 




HOPS, STROBILES. 



the fruit, or strobiles, which are also largely employed in the prepa- 
ration of malt-liquors, and are known as hops. Near their base are two 
small, round, dark seeds, covered with aromatic glands or grains, 
which are the active portion of the hops, and are termed lupulin. They 
are separated by threshing, rubbing and sifting the scales, and consti- 
tute from a sixth to one-tenth part of the weight of hops. 

Lupulinum (Lupulin) is official, and when fresh is a brownish- 
yellow granular powder which has the aromatic odor and bitter taste 
of hops. Microscopically it consists of two hemispheres ; the lower 
8 



114 MATERIA MEDIC A AND THERAPEUTICS. 

i 

somewhat conical, the upper top-shaped, and both reticulated ; within 
these is found a yellowish substance resembling vegetable pollen. 
Lupulin is slightly soluble in water, and is composed of a volatile oil, a 
bitter principle termed lupidite, resin, tannic acid and other matters. 
The scaly bracts contain a small portion of lupulinic matter. 

Physiological Effects. — Hops are locally sedative. Internally 
they are tonic and feebly ?tarcotic. The narcotic properties probably 
reside in the volatile oil, and the tonic properties in the bitter principle. 
They are said, also, to possess an aphrodisiac and astringent virtue, 
and sometimes prove diuretic. The odorous emanation is employed 
as an hypnotic by means of the hop-pillow. 

Medicinal Uses. — They are given to prevent chordee (in form 
of lupulin), and are also employed for their stomachic and tonic effect. 
The combination of tonic and hypnotic virtues renders hops an excel- 
lent remedy in mild forms of mania d potu. Topically, they are employed 
in the form of fomentation or poultice, in painful swellings, tumors and 
orchitis. As a soothing injection in vaginitis, and pruritis vagince, hops 
5j infused in boiling water Oij is recommended by Atthill, * and its 
efficiency is increased by the addition of borax 5j- 

Administration. — Hops are given in the form of infusion (not 
official — dose foij-iv), and tincture {tinctura humidi), dose foj-iij- 

The best preparation for internal use is Lupulin [lupulinum) in 
the dose of gr. v-xij, in powder or pills. The fluid extract of lupulin 
(extr actum lupulini fluidum) may be used in doses of foss-ij. It is best 
given mixed with a little syrup and then largely diluted. The oleoresin 
(oleoresince lupuli) is official, dose, TTUj-xxx, in capsules. 

DULCAMARA BITTERSWEET. 

Description, Habitat and Official Portion. — The young 
branches of Solanum Dulcamara, the Woody Nightshade {Nat. Ord. 
Solanaceae), a European vine, naturalized in the United States, possess 
combined narcotic and diaphoretic properties. 

Chemical Constituents. — The active principles are a poisonous 
alkaloidal glucoside termed solanine (C^H^NO^), which has been found 
also in S. tuberosum, or common potato, and S. nigrum, or black 
nightshade, and a glucoside, didcamarin (C^H^O^). 

Effects and Uses. — In small doses the most obvious effects of 
bittersweet are an increase in the secretion from the skin and mucous 

*" Diseases Peculiar to Women," 7th ed., p. 26. 



NARCOTICS— jETHER. 115 

surfaces, with some diminution of sensibility. According to Eloy's* 
investigations it is hypnotic, analgesic, mydriatic, and in large doses 
induces vertigo and tinnitus aurium. In excessive doses it is an acro- 
narcotic poison. Its precise use is not obvious, but as an analgesic it 
might be serviceable in neuralgia. 

Administration. — A fluid extract [extractum dulcamara fluiduni) 
is official; dose, f5j, largely diluted. 

ORDER II.— ETHEREAL ANAESTHETICS. 

The term Anaesthetics (from a, non and a'-ad'/jot^, sensation), 
properly speaking, includes all agents which diminish sensibility and 
relieve pain. It has, however, been used to denominate a class of 
ethereal remedies which are applied by inhalation, and produce such 
a condition of temporary insensibility as to prevent pain during sur- 
gical operations and parturition. 

The vapors usually employed to produce anaesthesia are those 
of ether and chloroform. Many other substances have, however, 
lately been introduced as anaesthetics. 

.ETHER ETHER. 

Preparation. — Ether is prepared by the distillation of alcohol 
and sulphuric acid, and is afterward rectified by redistillation with solu- 
tion of potassa. For inhalation, however, it is further purified by be- 
ing shaken with water, by which it is freed from alcohol, and this, as 
well as acid contaminations, are afterward removed by the agency of 
calcium chloride and freshly calcined lime. Thus purified, it used to 
be designated as aether fortior — stronger ether, a term now abolished 
from the U. S. P., the word .ether being applied to official ether. 

Although commonly termed sulphuric ether, in allusion to the 
sulphuric acid used in its preparation, ether contains no sulphuric 
acid. By the action of the acid upon alcohol, ether is formed by the 
substitution of ethyl (C 2 H 5 ) for one atom of hydrogen in alcohol 
(C 2 H 5 HO), and is ethyl oxide (C 2 H 5 ) 2 0. 

Properties. — Ether is a transparent, inflammable, colorless liquid, 
with a strong, fragrant odor and a hot taste. Its vapor, when mixed 
with air and ignited, explodes. It wholly evaporates in the air, so 
rapidly as to cause a considerable degree of cold ; combines with alco- 
hol and chloroform in every proportion, and dissolves in ten times its 
volume of water. The specific gravity of pure ether (or official ether) 

* V Union Medicate, 1886, p. 745. 



116 MATERIA MEDICA AND THERAPEUTICS. 

is 0.720 (consisting of about 96 per cent, of ethyl oxide and about 4 
per cent, of alcohol containing a little water). The boiling-point of 
ether is about 98 F. 

Aids. — Alcohol and chloroform enhance its effect upon the brain ; 
by inhalation, chloroform. 

Contraindications. — It should not be exhibited where fatty 
disease of the heart, or grave brain lesion (tumor, abscess), or serious 
obstruction of the lungs (emphysema), exists, or when from any cause 
there is unusual tendency to syncope, and precaution should be taken 
to guard against asphyxia ; but when administered with proper care 
and discrimination, it is attended with little or no danger or unpleasant 
results of any kind. 

Physiological Effects by the Stomach. — Its taste is hot and 
biting. When taken into the stomach, ether produces a primary 
stimulant and secondary narcotic effect, the stage of excitement be- 
ing, however, very transient. Before the narcotic effects set in, the 
heart's beats are increased, the face is flushed, and the skin becomes 
moist. 

Medicinal Uses. — It has long been employed as an antispasmodic 
and anodyne remedy in asthma, angina pectoris, and intestinal and gas- 
tric colic ; and, from its combined stimulant and antispasmodic virtues, 
it has been found useful in the latter stages of typhus, attended by sub- 
sultus tendinum, etc. In syncope, f5ss or more, it is one of the best 
stimulants to restore the heart's action, and may be combined with 
brandy or whiskey. The subcutaneous injection of ether is followed by 
pain and inflammation around the site of introduction, which usually 
subsides without suppuration. Thus administered, its systemic effects 
are more quickly produced than per orem. The deep injection is used 
in sciatica, and to bring about reaction after haemorrhage (especially 
post-partum), and failure of cardiac action. 

As a topical anodyne, ether is a very good application in nervous 
headache ; applied by means of an atomizer, it causes local anaesthesia ; 
it has also been used as a cooling lotion in cerebral affections. If 
evaporation be repressed, when it is applied locally it acts as a rube- 
facient, and may be employed for counter-irritation. 

Administration. — Dose, f5ss-j, to be increased when habitually 
used. It may be incorporated with water by rubbing it up with sper- 
maceti, in the proportion of gr. ij to ether f5j, or it may be given in 
capsules of gelatin. Ether should be preserved in tin cans, well stop- 
pered, and not kept near lights or fire. 



NARCOTICS— ^THER. 117 

By Inhalation. — The first effects of the inhalation of ether 
are a sense of strangulation and cough, from its local irritant 
action. When the vapor is absorbed into the system through the pul- 
monary surface, the nervous functions are successively and progress- 
ively affected. The mental faculties and volition become first impaired ; 
insensibility and unconsciousness rapidly supervene, during which sus- 
ceptibility to pain is lost \ and the patient lies in a trance-like sleep, resemb- 
ling death. This condition is often preceded by one of excitement, during 
which patients sometimes weep, laugh, moan, sing, rave, or present 
pugnacious manifestations. In the beginning of etherization the cir- 
culation is accelerated; but it is afterward depressed. The period of 
full ether-narcosis lasts from five to ten minutes, and the patient ordi- 
narily recovers without serious inconvenience, although headache, 
nausea, drowsiness and languor sometimes ensue for a few hours. 
Occasionally, congestion of the brain or lungs, cataleptic rigidity with 
prolonged insensibility, and, in females, hysterical phenomena, ensue 
after etherization ; but these effects are uncommon, and it is believed 
that death has rarely followed the use of ether when care has been 
taken to admit atmospheric air into the lungs along with the ether. 
During the stage of insensibility, convulsive twitches or muscular 
rigidity are occasionally noticed; the breathing is sometimes sterto- 
rous ; the iris becomes fixed ; the pupils are dilated ; the eyeballs are 
upturned ; and the orbicularis palpebrarum does not contract when 
touched. Insensibility to pain in some cases takes place before un- 
consciousness ; and when patients are recovering from the latter state 
the mental faculties are often completely restored, while insensibility 
to pain continues. A brief period of anaesthesia, lasting less than a 
minute, has been noticed to occur before complete insensibility, which 
may be taken advantage of for short operations. It has been shown 
by Flourens and Longet that when ether-narcosis is fully established 
the functions of the nerve-centres are involved in the following order, 
viz. : the cerebrum, the sensory centres of the cord, the motor centres of 
the cord, the sensory centres of the medulla oblongata, and lastly, the 
motor centres of the medulla oblongata. The functions which continue 
to act are those presiding over circulation and respiration. Ether * 
exists in the free state in the blood. It is mostly eliminated by the 
lungs, but little passing off by the kidneys. Ether-anaesthesia causes 
renal congestion and cloudy swelling. 

* University Medical Magazine, September, 1894, G. B. Wood, M. D. 



118 MATERIA MEDIC A AND THERAPELTICS. 

Since the year 1842, the inhalation of ether — first resorted to in 
our own country by Dr. Crawford W. Long, of Athens, Ga., and in 
1S46 by Dr. Morton,* a dentist of Boston, who got the idea that 
ether was adapted to anaesthesia from Dr. Jackson, a chemist — has 
been practised very generally in all parts of the world, with the great- 
est success, for the prevention of pain in surgical operations ; and its 
use has been also extended, with the happiest results, to the relief of 
pain in labor. 

The quantity of ether necessary to effect etherization is about two 
ounces ; and it may be conveniently applied by means of a cone of 
stiff-paper, shaped so that its base will fit over the nose and mouth of 
the patient, and into which a napkin or small towel, or hollowed-out 
sponge is placed ; the sponge should be first soaked in warm water, 
squeezed dry, and saturated with pure ether. It is then applied to the 
mouth and nostrils, the mouth being permitted occasionally to receive 
atmospheric air ; and, if irritability of the air-passages occur, this is 
to be gradually overcome. From three to thirty minutes are required 
to produce insensibility, and its occurrence is known by the closure of 
the eyelids (if they have been previously open), failure to respond to 
questions, and muscular relaxation. The sponge is then to be re- 
moved, and may be reapplied from time to time if necessary. 

All ages bear etherization well, and it has been given safely to an 
infant of a few hours, as well as to a female aged 92 (Coplinf). As to 
quantity and length of time, so much as foi9 have been required to 
bring a man under its influence, and for digital compression of an 
artery a man was kept under it thirteen hours without bad result. 
Drunkards and tipplers are difficult to etherize, and these cases should 
inhale a little chloroform first. 

Etherization is less apt to produce nausea if practised upon an 
empty stomach, and the administration of a hypodermic of morphia 
gr. 1^, prior to the inhalation, promotes its action. 

Precautions during Etherization. — There should be at hand a 
hypodermic syringe of strychnia gr. A, ammonia water, whiskey and 
digitalis, and a mouth-gag and tongue-forceps may be useful. If there 
be false teeth, they should be removed ; and the heart must be first 
examined. 

Toxicology. — The inhalation of ether is not entirely safe, as Dr. 

* Century Magazine, August, 1894. 

T Anesthesia, Therapeutic Gazette, 1892, p. 370; a practical paper. 



NARCOTICS— ^THER. 119 

Lyman * has collected a number of fatal cases (37). To revive the 
respiratory movements when suspended by ether-narcosis, the agents 
that must be employed are artificial respiration, faradization of the 
thoracic muscles, and inversion of the body according to Nelaton's 
plan ; hypodermics of strychnia revive the heart. 

Medicinal Uses. — Etherization has been resorted to in a variety 
of morbid conditions in which the administration of narcotics and an- 
tispasmodics has not proven potent enough. It exerts a powerful 
control over the violent types of spasmodic disease, and has been 
prescribed with advantage in hysteria, to control the spasm of tetanus, 
and strychnine poisoning, to prevent a paroxysm of asthma, chorea, 
convulsions, puerperal eclampsia, to alleviate the pain of biliary and 
nephritic colic, as a relaxant in the diagnosis and reduction of disloca- 
tions, in the examination and setting of fractures, for taxis in hernia, 
the breaking up of adhesions, and in the diagnosis of malingering. 
The extent to which etherization should be pushed varies, of course, 
with the nature of the disease and the acuteness of the pain. During 
the passage of calculi, for instance, it should be carried to the point of 
relieving the pain, while in dislocations complete anaesthesia is neces- 
sary. 

To relieve the pain of labor, complete narcosis should not be 
produced, as cessation of uterine contractions and loss of uterine 
retractility may result, leading to a delay in the delivery, retention 
of the placenta, and even post-partum haemorrhage. It should only 
be administered during the pains and intermitted between them, thus 
abating the suffering without abolishing voluntary efforts at expulsion. 

Instrumental or manual interference with labor may render com- 
plete anaesthesia necessary, or it may be desirable temporarily to aid 
in the relaxation of a rigid cervix, or to prevent the woman from bear- 
ing down when the perineum is endangered by a too rapid delivery. 

Local anaesthesia and congelation may be produced through the 
agency of the ether-spray applied to a part by the atomizer. 

.Either Aceticus (Acetic Ether, C^HgQH^C^). 

Preparation and Properties. — By mixing sodium acetate, spirit 
of wine, and sulphuric acid, and collecting by condensation the acetic 
ether that distills over. It is a colorless, fragrant ethereal liquid, con- 
sisting of 983^ per cent, by weight of ethyl acetate. 

Effects and Uses. — Its action resembles ether, but being less 

* "Artificial Anaesthesia," etc., 1881, p. 289. 



120 MATERIA MEDIC A AND THERAPEUTICS. 

volatile, is not so active. It may be given as a stimulant and 
carminative. 

Administration. — Dose, gtt. 15-30, in capsules, or syrup and 
water. 

CHLOROFORMUM CHLOROFORM. 

Preparation. — Chloroform is usually obtained from the distilla- 
tion of alcohol with chlorinated lime and consists of a liquid composed 
of " 99 to 99.4 per cent, by weight, of absolute chloroform, and 1 to 0.6 
per cent, of alcohol." 

Properties. — Chloroform (CMoroformuni) is a colorless, volatile 
liquid, of a bland, ethereal odor and a hot taste. It is not inflamma- 
ble, is slightly soluble in water and freely soluble in alcohol and ether. 
It has extensive solvent powers, dissolving camphor, the fixed and 
volatile oils, most resins and fats, iodine, bromine and the organic 
alkaloids. The purest chloroform has a specific gravity of 1.5022. 
Official chloroform has a specific gravity of 1.485- 1.490, when 
it contains a little alcohol ; and as usually found its specific gravity 
is about 1.475, when it contains more alcohol, and is less apt to 
become acid. The boiling point of pure chloroform is 142 F. It 
is chemically classed with the triatomic haloid ethers, and is methenyl 
chloride (CHC1 3 ). 

Tests. — Chloroform is sometimes contaminated with chlorinated 
pyrogenous oil (a very injurious impurity) ; this may be detected and 
removed by strong sulphuric acid, which gives the chloroform a color 
varying from yellowish to reddish-brown, according to the amount of 
impurity. The most delicate test for the presence of alcohol is iron 
binitro-sulphuret, which, when agitated with chloroform, will produce 
a brown tint if alcohol be present. AgN0 3 will detect the chlorides. 

Aids. — (See ether.) Locally by rubefacients, as camphor. 

Contraindications. — Chloroform, like ether, should not be 
administered by inhalation to persons suffering from any serious dis- 
ease of the brain or heart (especially fatty degeneration), or where any 
serious obstruction to the circulation exists. 

Physiological Effects by the Stomach. — Locally applied, and 
when its evaporation is prevented, chloroform acts as an irritant, and 
soon vesicates the skin — powerfully diminishing painful impressions 
during its application. Within the mouth its taste is hot, aromatic and 
saccharine. The effects of chloroform by the stomach on the system 
are analogous to those of ether, but much more rapid and powerful. 

By Inhalation. — When inhaled, in the dose of a fluidrachm or 



NAR CO TICS— CHL OR OFORMUM. 121 

more, it rapidly induces anaesthetic sleep, with a great relaxation of 
the muscles, gradual lowering of the blood-pressure, and the most 
complete insensibility to painful agents. The period at which insensi- 
bility occurs varies from fifteen seconds to two minutes, and it con- 
tinues usually between five and ten minutes, and may be prolonged con- 
siderably by renewal of the inhalation. The patient usually recovers 
without recollection of what has occurred during the state of insensi- 
bility, and with few or no uncomfortable sequelae. Sensibility to pain 
is often very much obliterated even before consciousness is lost. During 
sound sleep an individual may be chloroformed without being awakened. 

The introduction of chloroform as an anaesthetic — which pro- 
perty was first discovered by Sir James Y. Simpson,* in 1847, took 
place shortly after that of ether, and from its great intensity of 
action, its freedom from irritating effect on the bronchial mucous 
membrane, its more agreeable odor, and its non-inflammability, it has 
been extensively used, particularly in Great Britain, to the exclusion 
of ether. It should be administered in the recumbent posture with 
all constricting clothing loosened. A very considerable number of 
fatal cases have, however, occurred from the inhalation of this agent, 
where its administration did not appear in any way contraindicated ; 
and it cannot be considered a perfectly safe remedy. 

Toxicology. — The administration of chloroform has in many 
cases been attended with fatal syncope. (Lyman f has collected 
393 cases, due to alleged heart-paralysis). An elaborate investigation, 
however, made upon dogs as to its toxic action, conducted by the 
Hyderabad Chloroform Commission,! seems to negative this statement. 
They found " that chloroform does not paralyze the heart, but kills by 
stopping respiration." But this conclusion is not in accordance with 
the results reached by Wood and Hare, § who found in their investi- 
gations that the heart ceased beating before respiration stopped. Be 
this as it may, death has ordinarily occurred with such rapidity as to 
render remedial interference almost unavailable; but at the slightest 
approach of poisonous symptoms as shown by pulse-failure, facial 
lividity, gasping or stertorous breathing, the inhalation must be stopped, 
the patient placed in the recumbent position, the head lowered and 



* Century Magazine, January, 1894. 

f" Artificial Anaesthesia, etc." 1881, p. 136. 

X Lancet, London, Jan. 18, 1890, 

\ Medical News, Feb. 22, 1890. 



122 MATERIA MEDIC A AND THERAPEUTICS. 

the tongue drawn forward with catch-forceps, cold affusions applied, 
and, above all, artificial respiration practised. Other means that may 
be resorted to in restoring animation are electro-magnetism to the 
respiratory muscles, the inverted position of Nelaton, and injections 
subcutaneously of ether or ammonia water. 

Medicinal Uses by the Stomach. — Chloroform is prescribed by 
the stomach as an anodyne and antispasmodic, in all cases to which 
ether is applicable, and has the advantage of a more agreeable taste. 
It has been found particularly useful to relieve the pain and vomiting 
of cancer of the stomach, and also in intestinal colic and in cholera. For 
diarrhoea and colic a good formula is — R Spiritus chloroformi, f5ss ; 
tincturae capsici, TTLv-x ; morphinae sulphatis, gr. J^ ; aqu^e, f§ss. M. 
S. — One dose. Topically it is used as an anodyne. The editor has 
used the deep injection of chloroform, Ttlx-xx in sciatica, with good 
results — the injection to be made over the nerve. A lotion applied to 
pediculosis pubis will destroy the parasite. 

Medicinal Uses by Inhalation. — It is employed as an anaesthetic, 
anodyne and antispasmodic, to fulfill the indications to which ether is 
applicable. I?z labor chloroform should not be given until complete 
dilatation of the os has taken place, the head descending and the pains 
propulsive.* It should be inhaled only when the pains come on, and 
there is no doubt that its entire safety in obstetric practice is due to 
the intermittent plan of administering it. Its non-inflammability, too, 
in midwifery, should not be lost sight of. By inhalation, when other 
means have failed, it may prove serviceable to control the spasms of 
rabies in conjunction with hypodermics of morphia. 

Administration. — Dose from Tttxv to f3ss in sweetened water, or 
it can be had in 5 and 1 5 TTL capsules, to be repeated, or chloroform- 
water {aqua chloroformi) (f5j - j v -) rnay be given. As an anti-neuralgic 
liniment, fgj to f.^ij of camphor liniment; or as a rubefacient and 
anodyne, undiluted, on linen, covered with oiled silk, to prevent evap- 
oration. As a wash or gargle, f5j or ij to water Oj ; hypodermati- 
cally, TTLx-xx. 

The dose for inhalation is a fluidrachm, to be repeated in two 
minutes if anaesthesia be not produced ; and its effects may be renewed 
from time to time without injury. It may be applied on a handker- 
chief, held near the nose or mouth, care being taken to allow a proper 
admixture of atmospheric air, and to give it on an empty stomach. 

A solution of chloroform in ether has been used in the United 

*Playfair, 5th ed., vol. i,p. 353. 



ETHEREAL ANAESTHETICS. 123 

States, but, from the unequal volatilization of the two liquids, it must 
be difficult to modify their effects by combination. The A. C. E. mix- 
ture consists of rectified spirits I, chloroform 2, and ether 3 parts, and 
is much employed as an anaesthetic in obstetrics, 

Spiritus Chloroformi {Spirit of Chloroform) is a solution of chloro- 
form in alcohol ; a convenient form for internal exhibition. Dose, 
f5j. Serviceable to relieve headache where a mild stimulant is indi- 
cated. 

Linimentum Chloroformi {Chloroform Liniment) is made by mixing 
30 parts of chloroform with 70 parts of soap-liniment. Useful as a 
stimulating application in chilblain, lumbago, myalgia, etc. 

Emulsum Chloroformi {Emulsion of Chloroform) is made by mixing 
chloroform 40 parts, tragacanth 15 parts, dissolved, with water 1000 
parts, to which is added expressed oil of almond 60 parts. Dose, 
fgss-j.* 

Since the discovery of the anaesthetic properties of ether and 
chloroform, many other substances have been employed for the pur- 
pose of anaesthesia. Of these may be mentioned : 

I. Methylene Bichloride, (CH 2 C1 2 ), (not official). — This liquid in- 
troduced to the profession by Dr. W. B. Richardson in 1867 (known 
also as dichloromethane), is most easily procured by the action of 
nascent hydrogen (developed from zinc, water, and sulphuric acid) 
upon chloroform. It is a colorless fluid, having a pleasant, ethereal 
odor, like that of chloroform, boils at %Z° F., has sp. gr. 1.34, and 
mixes with ether and chloroform in all proportions. The vapor of 
methylene bichloride is pronounced by Mr. Spencer Wells to be the 
best known anaesthetic. Given properly diluted with air, according to 
his method (in an experience of more than a thousand cases), it has 
proved of uniform certainty and rapidity of effect, and free from any 



* Under the name of chlorodyne a combination containing chloroform is much used, for 
which the following is a formula: morphine hydrochlorate, 8 grains; oil of peppermint, 16 
minims; stronger ether, a fluid ounce; extract of liquorice, 2^ Troy ounces; pure chloroform, 
stronger alcohol, and molasses, each 4 fluid ounces ; diluted hydrocyanic acid, 2 fluid ounces ; 
syrup, \"J]/z fluid ounces; dissolve the morphine and oil in the alcohol, and add the chloro- 
form and ether, mix the liquorice, syrup and molasses, shake the two mixtures, and add the 
hydrocyanic acid; dose, 5 to 10 minims, the vial to be well shaken. An analysis of Brown's 
chlorodyne made in 1892 shows it to contain 15 per cent, of chloroform and 2 grains of 
morphia per ounce. 

Numerous other formulae for chlorodyne have been published, but the above more nearly 
resembles the original preparation sold under this name. This remedy is often very service- 
able in cholera morbus and infantum and acute diarrhoea. 



124 MATERIA MEDIC A AND THERAPEUTICS. 

dangerous symptoms. It is used in about the same dose as chloro- 
form, but has not been much employed in the United States. Nine 
fatal cases from its employment are recorded. * 

II. Nitrous Oxide Gas, (N0 2 ), was the substance by which anaes- 
thesia was in the first instance produced, in the hands of Mr. Horace 
Wells, a dentist of Hartford, Connecticut, in 1844. 

Preparation and Properties. — Its anaesthetic properties were 
known to Sir Humphrey Davy in 1779. It is made by the decompo- 
sition of ammonium nitrate by heat. It is a colorless, respirable gas, 
absorbable by water, and the solution, like the gas itself, has a faint, 
agreeable odor, and sweet taste. 

Physiological Effects. — This gas is both a pleasant and efficient 
anaesthetic, more rapid and at the same time more transitory (about 
y 2 minute) in its action than either ether or chloroform, and almost 
free from disagreeable or serious consequences. It is given sitting up. 
During unconsciousness, it causes considerable mental excitement, 
shown in various ways, as laughing, crying, etc., and lividity of the 
face. Buxton,f who has investigated its action, sums it up as follows: 
By trephining a dog and administering nitrous oxide gas, he observed 
the normal vermilion hue of the superfices change to purple, stasis 
within the vessels, and the brain substance to increase in size; the 
cord viewed similarly was found also augmented in volume, so that 
some cerebro-spinal fluid was squeezed out. In both experiments the 
results obtained were the reverse of those induced by asphyxia, to 
which nitrous oxide unconsciousness has been attributed. Buxton 
considers its anaesthetic action due to its own inherent sedative virtues, 
and as far as asphyxia is concerned seems to have proved his position. 
The heart's action and blood-pressure are not much altered. The res- 
piratory movements are primarily quickened, then slowed, and finally 
extinguished — probably by paralysis of the centre. The heart contin- 
ues to beat for a short time after the stoppage of respiration. Certain 
peculiar phenomena are occasionally encountered, as muscular rigidity 
followed by flaccidity, loss of the superficial reflexes, persistence of 
knee-jerk, and less frequently involuntary evacuation of the bladder 
and rectum, and excitation of the sexual organs. 

Toxicology. — Lyman % has collected only four fatal cases which 

*Brit. Med. Journ., 1883, ii, 104. 

f Transactions of the Odontological Society of Great Britain, 1886-7, p. 90. On the 
Physiological Action of Nitrous Oxide Gas. 
\ "Artificial Anaesthesia," etc., 1881. 



ETHEREAL ANESTHETICS. 125 

can be fairly attributed to nitrous oxide gas, though others have since 
been reported. 

Medicinal Uses. — It is well adapted to employment in the extrac- 
tion of teeth, or, in short minor surgical operations ; but its effects are too 
transient for the anaesthesia required in protracted operations. The 
amount necessary to produce anaesthesia (one or two gallons), as well 
as the complicated apparatus required for its administration, constitute 
also an objection to its general use. 

Administration. — It is best administered from an india rubber 
bag, containing about eight gallons of the gas, furnished with a mouth- 
piece with two valves, one of which is designed for the throwing out of 
the respired gas . 

III. Ethyl Bromide, (C 2 H 5 Br), (not official) is an anaesthetic 
which a few years ago bid fair to supersede ether and chloroform, but 
the occurrence of several fatal cases under its administration led to the 
abandonment of its use, and it is now seldom resorted to. Ott* states 
that it destroys life either when inhaled or administered subcutaneously, 
by a toxic action on the respiratory centre. 

LOCAL ANiESTHESIA. 

For the relief of pain during minor surgical operations, as the 
opening of abscesses or the extirpation of small tumors, local ancesthesia 
may be resorted to. This consists in congelation of the part by means 
of a freezing mixture (as ice and salt, which, when applied for three 
minutes to the integument, causes a thorough deadening of sensation 
in the superficial structures); or in spraying the part with some sub- 
stance, as ether or ethyl bromide, which by its rapid evaporation 
produces the same effect; or the same purpose may be effected 
by the application of remedies like cocaine (a. v.), or carbolic acid 
{q. v.), which depress the sensory nerves of the part to which they 
are applied, thus deadening sensation. Rhigolene (not official), one 
of the lighter distillates of petroleum, is employed to produce local 
anaesthesia. When sprayed upon a part it reduces the temperature 
to about 1 5 F., abolishing cutaneous sensibility, hence its use in minor 
surgery. It is inflammable, and its diffusive vapor when mixed with 
air may explode. It is administered by a spray-apparatus. 

Carbon Disulphidum, {Carbon Disulphide), (C. S). 

*" Bromide of Ethyl; Its Toxicological Action." I. Ott, pamphlet. See also Therap. 
Gazette, pp. 365 and 577, 1892, E. E. Montgomery. 



126 MATERIA MEDICA AND THERAPEUTICS. 

Source and Properties. — A highly inflammable, colorless, vol- 
atile, diffusive liquid, of characteristic odor, easily made from its ele- 
ments. Its taste is aromatic and sharp. 

Effects and Uses. — By inhalation it causes rapid but transient 
anaesthesia. When sprayed on a part it produces local anaesthesia. 

ORDER III.— ANTISPASMODICS. 
Antispasmodics are medicines that allay irregular nervous action. 
Their effects upon the economy in a state of health are not very decided, 
and are limited to a slight stimulation of the circulation and exhilara- 
tion of the mental faculties. Their proper influence is, however, strik- 
ingly shown in certain deranged conditions of the nervous system, 
particularly those forms of spasm which depend upon idiopathic or 
primary nervous disorder, and are known under the designation of 
hysteria. They are also useful in many varieties of mental disturbance, 
as wakefulness, hypochondriasis, and even insanity, and are often pre- 
ferable to narcotics in the treatment of these cases, from their compara- 
tive freedom of action on the brain. They are all distinguished by a 
powerful odor. 

ASAFCETIDA — ASAFETIDA. 

Description, Habitat and Preparation. — Asafetida is a gum- 
resin obtained from the root of Ferula fcetida {Nat. Oi'd. Umbelliferae), 
and is derived from Afghanistan. Though these are the sources given 
by the U. S. P., yet its exact derivation has not yet been proven.* The 
plant has a long tapering root, the size of a man's leg, and an erect 
stem, from six to nine feet in height, rising from the midst of the leaves. 
The drug is obtained from incisions into the root, or by taking suc- 
cessive slices of it. The exuded juice is scraped off, hardened in the 
sun, and afterward packed for exportation. 

Properties. — It occurs in masses of varying size, consistence, and 
color, but is usually whitish, intermixed with darker spots, and becomes 
reddish, and finally brown, by exposure to the air. It is sometimes 
soft and adhesive, at other times hard and brittle, and is not readily 
powdered except at a low temperature. It breaks with a waxy lustre, 
and the best samples appear to be composed of irregularly-shaped tears. 
Its odor is powerful, alliaceous, and fetid. 

Chemistry and Constituents. — Asafetida is a gum-resin united 
to an alliaceous volatile oil. The gum is dissolved by water, and the 
mucilage thus formed suspends the resin and volatile oil. The resin 

* Pharmacographia, 2d ed., p. 314. 



ANTISPASMODICS. 127 

and volatile oil are soluble in alcohol; but the tincture becomes milky 
on the addition of water, owing to the separation of the resin. The 
resin contains ferulaic acid (C ]0 H l0 O 4 ) and umbelliferon (C 9 H 6 3 ), and 
when fused with potassa, yields resorcin. 

Physiological Effects. — The taste of asafetida is acrid and dis- 
agreeable. When taken into the stomach it produces a local stimulant 
and carminative effect. After absorption, it proves a moderate excitant 
and exhilarant, and exerts a marked antispasmodic influence upon 
morbid conditions of the nevous system. Large doses cause nausea 
and vomiting. It also stimulates the mucous secretions generally, and 
increases the peristaltic action of the bowels, inducing soft, offensive 
stools. Its volatile oil is absorbed, and the odorous principle is recog- 
nized in the secretions, especially in the perspiration. 

Medicinal Uses. — No medicine used to be more highly esteemed 
as an antispasmodic than asafetida; but it is now not often employed, 
because more efficacious and less disagreeable remedies have super- 
seded it. It is resorted to in the various forms of hysteria, and is valu- 
able in relieving the mental depression which constitutes one of the 
protean types of this disorder, gr. v every 3 or 4 hours. In certain 
affections of the abdominal viscera, as flatulent colic and costiveness, 
asafetida is often useful as an antispasmodic and laxative enema. In 
flatulent colic occurring in children, the emulsion in doses of f5j will 
generally give speedy relief. In tympanites, especially in hysterical 
patients, or when accompanying constipation, nothing proves more 
serviceable than enemata of the emulsion, or suppositories (containing 
the equivalent of Tftxl of the tincture). Enemata of the emulsion have 
been used for the tympanites occurring in typhoid fever, but from the 
laxative effects of asafetida turpentine is to be preferred in these cases. 

Nothwithstanding its disagreeable odor, this drug is largely used 
as a condiment in Asia; and even in the refined cookery of Europe its 
flavor is admired. Some persons take it habitually for its exhilarant 
effects ; and when used as a medicine, it generally becomes acceptable. 

Administration. — Dose, gr. v to xx, in gelatin-capsules, or sugar- 
coated pills. The emulsion (emidsum asafcetidcz, — 4 parts to water 100 
parts) is given in the dose of fe>ss-j, repeated, or as an enema, fgij-iv. 
The emulsion from its whiteness and opacity, is sometimes called lac 
asafcetidce, or milk of asafetida. Pills of asafetida (pilidce asafoetidce) 
are official, each pill containing gr. iij of the gum-resin. The tincture 
(tinctur a asafoetidce 20 parts to 100 of the tincture) — dose f5j. Pills of 
aloes and asafetida (pilules aloes et asafoetidce), are also official. 



128 MATERIA MEDICA AND THERAPEUTICS. 

AMMONIACUM— AMMONIAC. 

Description and Habitat. — This is a spontaneous gum-resinous 
exudation obtained from Dorema ammoniacum [Nat. Ord. Umbelli- 
ferae), a plant of Persia. 

Properties and Chemistry. — It comes in tears or lumps, of an 
irregular shape, yellowish on the outside, whitish within, is moderately 
hard and brittle, and has an unpleasant, bitter, and rather acrid taste, 
with a peculiar smell, somewhat like that of galbanum. It is a gum- 
resin, with a little volatile oil, the latter free from sulphur. Resorcin, 
but no umbelliferon, is obtained from the resin. 

Effects and Uses. — Its effects are similar to those of asafetida ; 
but it is seldom used except as an antispasmodic expectorant in chronic 
bronchitis. 

Administration. — Dose, gr. x to xxx. An emulsion, {emidsum 
ammoniac!) , 4 parts to water 100 parts, dose f5j to f-5^, is official. A 
plaster of ammoniac with mercury (emplastrum ammoniaci cum hydrar- 
gyro) is also official. 

CAMPHORA— CAMPHOR. 

Description, Habitat and Varieties. — Camphor is a stearop- 
ten of the nature of a ketone, derived from Camphora Cinnamo- 
mum, the Camphor-Laurel {Nat. Ord. Laurineae), a large evergreen 
tree of China, Japan, and the island of Formosa. All parts of the 
tree are strongly impregnated with camphor, which is obtained from 
the chips of the roots and branches by subliming them with water and 
collecting the condensed camphor in pots. In this state it is known 
in commerce as crude camphor, and consists of dirty grayish grains 
adhering in crumbling masses. Japan camphor (called also Dutch 
camphor, because introduced to commerce from Nagasaki by the 
Dutch colonists), has a pinkish color and is purer though coarser than 
the China camphor. A valuable camphor * is known in the East, 
which is found in a concrete state in the cavities and fissures of the 
trunk of Dryobalanops Camphora [Nat. Ord. Dipterocarpaceae), a tree 
of Borneo and Sumatra. By tapping the tree, or as a natural exuda- 
tion, a camphor-oil is obtained (DeVriese loc. cit.), which must not be 
confounded with that of the laurel-camphor. 

Properties and Chemistry. — The crude camphor, as imported 
from Canton and Japan, is not found in the shops until it is purified 
by resublimation with quick-lime, when it is termed refined camphor. 

*Journ. of Pharmacy, xii, p. 22. On the Camphor of Sumatra ; De Vriese. 



ANTISPASMODICS. 129 

This occurs in large hemispherical or convex-concave cakes perforated 
in the middle. It is solid at ordinary temperatures, soft and some- 
what tough, but may be readily powdered by the addition of a few 
drops of alcohol, chloroform, ether, or equal weight of sugar. It is 
translucent, has a strong fragrant odor, and a characteristic cooling 
taste. It is volatile, highly inflammable, lighter than water, and very 
slightly soluble in it, but soluble in alcohol, ether, chloroform, oils 
and acids. Camphor has the formula C 10 H 16 O, and is chemically a 
ketone. It forms substitution compounds with chlorine, bromine and 
iodine. The so-called oil of camphor is a complex mixture containing 
terpenes, cincol, safrol, eugenol, etc., and is obtained as a by-product 
in the preparation of crude camphor. By passing hydrochloric acid 
gas into oil of turpentine a crystalline substance is obtained called 
artificial camphor, but. which has the composition C 10 H 16 HC1. By 
the action of nitric acid on camphor camphoric acid (C 10 H 16 O 4 ) is ob- 
tained, 

Incompatibles. — Water precipitates camphor from the spirit of 
camphor. 

Aids. — The cerebral excitants, as cocaine, cannabis Indica, ether, 
chloroform and alcohol. 

Physiological Effects. — The local action of camphor is anae- 
sthetic and rubefacient, and to the mucous membrane irritant. Its 
taste is aromatic, bitter, and afterward cooling. After its absorption, 
its effects, in small doses, are moderately stimulant, exhilarant and 
anodyne. In large doses, it causes considerable disorder of the 
cerebro-spinal system, depression of the circulation, and diaphoresis ; 
and in excessive quantity it acts as a narcotico-irritant, occasioning 
burning heat in the stomach, violent cerebral convulsions, and maniacal 
delirium. No deaths from camphor, however, have been reported in 
healthy adults. In small doses, gr. v, owing no doubt to the stimula- 
tion of the circulation, it is aphrodisiac ; in full doses, gr. xx, anaphro- 
disiac. Camphor is eliminated by the breath, skin, and urine, and it 
has been detected in the blood. In cases of poisoning, after evacuat- 
ing the stomach, demulcents, opium and wine are to be administered. 

Medicinal Uses. — From its combined antispasmodic and dia- 
phoretic powers, camphor is a valuable remedy in the treatment of 
acute dysentery and cholera in the initial stage, and, is much employed 
in these diseases, either in combination with opium or as a substitute 
for the latter; R Spiritus camphorse, tincturse opii, aa TTLx. M. S. 
Every i or 2 hours, in a little water. In the early stages of summer 
9 



130 MATERIA MEDICA AND THERAPEUTICS. 

diarrhoea it is also frequently prescribed, and for this purpose the 
spirit may be given gtt. x-xx, and repeated p. r. n. with paregoric. As 
a diaphoretic stimulant and antispasmodic, it is useful in the low stages 
of fevers. In many forms of mental disorder it calms irritability, re- 
lieves despondency, and induces sleep. In chordee large doses are 
required — gr. x-xx. Milton * considers f5ss-j of the spirit in water 
before retiring the best remedy for this complaint. He repeats the 
dose every time the patient awakes with chordee. On account of its 
pungency the administration of the fluid preparations of camphor is 
objectionable. Bumstead f gave it in pill, gr. iij-vj, at bed-hour, com- 
bined with opium. Camphoric acid % (5j4 m 2 4 hours) has recently 
been shown to possess antisudorific properties against the sweating of 
phthisis. Topically, camphor, (the liniment), is employed as an anodyne 
in chronic rheumatism ; and the powder, against the itching and burning 
of erythema and intertrigo, mixed with starch and zinc oxide. Powdered 
camphor sniffed into the nostrils is a good remedy in acute nasal catarrh, 
hay fever and influenza, or it may be volatilized in hot water (5j to O j£), 
and its fumes inhaled through a paper-funnel ; it also enters into t,he 
composition of tooth-powders (saturated alcoholic solution of camphor 
grt.vj,in precipitated chalk Sj). 

Administration. — The medium dose in substance is gr.v-x ; 
but it may vary from gr.j to xx. It is best given in pill or capsule. 
Equal parts of camphor and chloral make a pleasant rubefacient lini- 
ment, of service in sprains, lumbago, affections of 'the joints, etc. 

Aqua Camphorae {Camphor- Water). Dose foj (containing about gr.ij) 
to foij or iij. It is added to collyria, foj to f§j. The spirit [spiritus 
.camphorce) is used as an embrocation ; but it may be given internally on 
.a lump of sugar, in the dose of gtt.v to foj — a serviceable remedy di- 
luted with water to relieve headache where a gentle stimulant is indi- 
cated ; and to check hiccough. 

Hope's Camphor Mixture (not official) consists of camphor-water, 
foviij ; nitrous acid, foj ; laudanum, gtt.xxv ; dose, f§ss, repeated. This 
preparation is an efficient remedy in the treatment of acute diarrhoea 
and dysentery. 

Linimentum Camphorae (C am plwr- Liniment) consists of camphor 
..(20 parts) dissolved in cotton-seed oil (80 parts) ; a mild embrocation. 

* " On the Pathology and Treatment of Gonorrhoea," etc., 1887, p. 167. 
f" Pathol, and Treat, of Venereal Diseases," 1883, p. 91. 
J " Bull. Gen. de Therap.," 1891, t. i. p., 14. 



ANTISPASMODICS. 131 

Ceratum Camphorae (Camphor- Cerate) is made by mixing camphor- 
liniment (i part) with white wax (3 parts), and incorporating the 
mixture with lard (6 parts). 

Linimentum Saponis (Soap-Liniment) is made by digesting soap 
and camphor with oil of rosemary in alcohol and water. It is a yellow, 
oleaginous liquid, and is used as an anodyne and gentle rubefacient 
application in gouty and rheumatic pains, chilblain, sprains, bruises, 
lumbago, myalgia, and affections of the joints. It is useful to cleanse 
the skin in stearrhcea, and should be followed by an application of 
lime-water. It is also frequently combined with other liniments, as 
those of chloroform or ammonia. 

Camphor Cream (not official) consists of camphor and laudanum 
each fgij ; ammonium carb., oj ; oil of origanum, tSij ; water q. s. ad 
Oj. M. S. Makes into a cream ; employed in chaps, eczema, etc. 

Camphora Monobromata (Monobromated, Camphor) (Ci H 15 OBr), 
is prepared by letting fall a stream of bromine upon powdered camphor 
till the latter is liquefied, then boiling the mixture in a water-bath, 
and afterward dissolving in alcohol and crystallizing. It occurs in 
long, colorless, acicular crystals, having an odor of camphor and tur- 
pentine and a slightly bitter taste, insoluble in water, but soluble in 
alcohol, the fixed and volatile oils, ether, carbon bisulphide, and chlo- 
roform. It is a substitution compound, one atom of bromine taking 
the place of an atom of hydrogen in laurel-camphor. 

Administration. — Dose for an adult, gr. v, repeated, in pills or 
tablets. 

VALERIANA — VALERIAN. 

Description, Habitat and Official Portion. — Valeriana offi- 
cinalis, or Wild Valerian (Nat. Ord. Valerianaceae), is a perennial 
European plant growing to the height of three or four feet. The 
rhizome and rootlets are the portions used, and consist of numerous 
. brown, slender, brittle fibres, attached to a rough, yellowish-brown, 
tuberculated head. When powdered, it is yellowish-gray. It has a 
peculiar, powerful odor, of which cats are fond, 

Chemistry and Constituents. — Water and alcohol extract its 
virtues, which depend on the presence of a volatile oil, and a colorless 
volatile acid, called valerianic, may be separated either from the oil 
or root. 

Physiological Effects. — It has a bitterish, sub-acrid, aromatic 
taste. In medicinal doses, valerian improves digestion and appetite, 



132 MATERIA MEDICA AND THERAPEUTICS. 

decreasing the urinary flow and excretion of urea (Yvon*). Large 
doses occasion eructations, colic and diarrhoea, excitement of the 
circulation, diaphoresis, and increased urinary flow. The effect of 
valerian on the nervous system is not constant, as it is sometimes 
excitant, and again calming. The hypodermic injection of valerian oil 
reduces the reflex excitability of the spinal cord, and antagonizes in 
frogs the tetanic spasms of strychnine. 

Medicinal Uses. — It is prescribed as a nervous excitant and anti- 
spasmodic in the various forms of hysteria and melancholia, to control 
the active manifestations of which it may be prescribed with asafetida: 
R Tincturae Valerianae ammoniatae, tincturae asafcetidae, aa f5j. M. S. 
— One dose. Moral influence, however, in this sad condition is mostly 
superior to medicine. Occasionally it is given in hypochondriasis and 
in nervous headache, and as it lessens the urinary flow it may prove 
serviceable in diabetes insipidus. 

Administration. — Dose of the powder, from 5ss-jss, three or four 
times a day; of the tincture {tinctura Valeriana) (20 per cent, in 
diluted alcohol), f 5j ; of the ammoniated tijicture (tinctura Valeriana 
ammoniatd) (20 per cent, in aromatic spirit of ammonia — an excellent 
preparation), f5j to ij ; of the fluid extract y (extraction Valeriana 
fluidum), f5j. 

Ammonii Valerianas {Ammonium Valerianate), (NH 4 C 5 H 9 2 ). — 
This salt, made by combining valerianic acid with ammonia, occurs in 
snow-white quadrangular plates, of an offensive odor like that of 
valerianic acid, and a sharp, sweetish taste. It deliquesces in a moist 
air, effloresces in a dry one, and is very soluble in both water and 
alcohol. Potassa and the mineral acids decompose it. It is employed 
as an antineuralgic and antispasmodic in neuralgia, nervous headache 
and hysteria. 

Administration. — Dose, gr. ij-viij, given in coated pills; or an 
elixir, prepared with aromatics, may be used. 

CYPRIPEDIUM LADIES' SLIPPER. 

Description and Habitat. — The rhizome and root of Cypri- 
pedium pubescens and of Cypripedium parviflorum {Nat. Ord. Orchi- 
daceae), common indigenous plants, known under the names of 
moccasin-plant, are recognized by the U. S. Pharmacopoeia. 

Properties and Chemistry. — The dried root is several inches 

*Arch. de Neurol, xix, 1890, p. 229. 



ANTISPASMODICS. 133 

long, bent, with a small, knotted, dark head, and numerous fibres of 
yellowish-brown color. It contains a volatile oil, volatile acid, and 
resin, and has been used as a substitute for valerian. 

Administration. — Dose of the fluid extract (extr actum cypripedii 
fluidum), TTLx-xx. 

SCUTELLARIA — SKULLCAP. 

Description, Habitat and Properties. — The herb of Scutellaria 
laterifolia, (Nat. Ord. Labiatae), an indigenous, perennial herb, found in 
moist localities, growing to the height of one or two feet, containing a 
crystalline bitter glucoside,* is considered by many American practi- 
tioners .to possess antispasmodic properties. 

Administration. — A fluid extract (extr actum Scutellaria fluidum) 
is official, dose Tft v-xx. An infusion may be had. 

The following vegetable substances, used as articles of diet, may 
be ranked also with antispasmodics : — 

I. Thea — Tea (not official), the dried leaves of Thea chinensis 
(Nat. Ord. Ternstromiaceae), an evergreen shrub of China, India and 
Japan, whence the markets of the world are supplied. The most 
important constituents of tea are essential oil (upon which the flavor 
depends), tannic acid, an alkaloid termed theme, discovered by Oudry, 
in 1827 — identical with caffeine — and boheic acid. According to 
Attfield f and others, theine or caffeine is the alkaloid of tea, mate, 
guarana and kola-nut. Dr. Mays \ found it to be analgesic, and he 
has employed it, gr. tV-I, subcutaneously for the relief of pain, though 
his experience was not entirely confirmed by Castle. || A strong cup 
of tea is a good remedy for headache. 

II. Caffea — Coffee (not official), the seed of Coffea arabica (Nat. 
Ord. Rubiacese), a small tree which is a native of southern Arabia and 
Abyssinia, and is cultivated in various tropical and semi-tropical 
countries. Coffee contains a neutral, insoluble, alkaloid, caffeine, 
(q. v.), designated by the U. S. P. as a feebly basic proximate principle, 
(which is methyl-the obr omine , isomeric with theine), and two peculiar 
principles, one resembling tannin, termed caffeo-tamiic acid, and the 
other termed caffeic acid. The volatile oil, upon which the flavor 
depends, is developed by roasting. Coffee may be used for the 

* Am. Jour. Pharm., Nov., 1889. 

f " Chemistry, Gen., Med. and Pharm.," 10th ed., p. 398. 

\ Medical News, April, 1 886. 

|| Cincinnati Lancet and Clinic, Jan,, 1886. 



134 MATERIA MEDICA AND THERAPEUTICS. 

general indications of antispasmodics, and is, besides, especially effi- 
cacious in relieving the sopor caused by opium-poisoning. Both tea 
and coffee lessen the urea in the urine. Coffee is relaxing, while tea is 
astringent, since it contains tannin. Salivary digestion is retarded by 
tea, * in part owing to its tannin j theine, caffeine or the volatile oil 
exert no action on it, while coffee and cocoa are indifferent. Gastric 
digestion is restrained by tea, coffee and cocoa, ranking in this order ; 
on pancreatic digestion they exert no influence. This kind of inhibi- 
tion is not abnormal, as it contributes to a beneficial end, slow being 
quite different from imperfect digestion. 

Caffeina, {Caffeine), (C 8 H 10 N 4 2 + H 2 O). — Grains J^-iij produce 
decided cerebral effects, as excitement, wakefulness and hallucination, 
and, when exhaustion sets in, sopor. It increases the number of the 
heart's beats, and raises the arterial pressure, both being followed by 
feeble action and diminished blood-pressure. In frogs the motor and 
probably the sensory nerves are affected by it. Injected into dogs 
and cats, it produces tetanus (Aubert). In cats f the increased flow 
of urine is coincident with dilatation of the blood-vessels, and it aug- 
ments the volume of the kidneys. Applied to a cut-out muscle, it 
causes rigidity (coagulates the myosin) and abolishes the electrical 
contractility. Caffeine elevates and then lowers the animal tempera- 
ture, and has decided diuretic powers (Gubler). Its efficacy in 
diminishing the dropsy of cardiac and other affections, by increasing 
the urinary flow, has been investigated by Stahl,| who reports favor- 
able results from its employment. In man gr. vij-xij have caused 
decided cerebral effects; but no deaths have followed its use. Caffeine 
has been used as a cerebral stimulant in migraine (gr. j-ij), in cardiac 
dropsy (gr. v.), being a powerful diuretic, and to antagonize morphine 
narcotism. 

Administration. — Caffeine citrate {caffeina citratd), effervescent ci- 
trate d caffeine {caffeina citrata effervescens}, and caffeine, {caffeina), are 
the official salts; dose, gr.^-ij. The citrate is given in pills or tablets, 
the effervescent citrate in water. Caffeine valerianate is useful in hys- 
terical vomiting, in the dose of j-ij, repeated. 

III. Theobroma. — Chocolate (noticed more at length under the 
head of demulcents — see Oil of TJieobroma) contains a nitrogenous 
principle, theobromine, nearly identical in composition with caffeine 

* fl Lectures on Dietetics and Dyspepsia," 1886, p. 28, et at. Wm. Roberts. 
I Jo urn. of Physiol., 1887, viii, p. 1 1 7. Experiments by Phillips and Bradford. 
% " Inaug. Diss." Wurzburg, 1887. 



ANTISPASMODICS, 135 

(C 7 H 8 N 4 2 ). Sodio-salicylate of theobromine under the name of Diu- 
retin has been recently used as a powerful diuretic; dose, gr. x-xx, t. d. 

IV. Coca. — The leaves of Erythroxylon Coca (Nat. Ord. Linese), 
have long been used as a masticatory by the Indians in Peru for 
the purpose of enabling them to undergo fatigue, hunger and thirst. 
An alkaloid termed cocaine (C 17 H 21 N0 4 ) is found in coca, also coca- 
tannic acid, which yields with the iron- salts a green precipitate. 
Hydrochloric acid is also incompatible, as it splits cocaine into 
methylic alcohol, benzoic acid and ecgonine. Chewing the leaves 
produces a temporary benumbing effect on the tongue. The most 
interesting internal effects of coca in man are cerebral stimulation, 
lessening of the feeling of fatigue, the ability to remain for a long time 
without food, increased cardiac action and elevation of temperature. 
Coca * lessens the excretion of urea and the urinary flow. Large 
doses cause muscular weakness, drowsiness and tinnitus aurium (Ott). 
Coca has been but little used in medicine, though its use is indicated 
in diseases requiring the checking of tissue waste, as phthisis. In 
cases of mental and physical fatigue [exhaustion) dependent on over- 
work, the wine or fluid extract repeated until the condition is relieved 
is a remedy of great value. 

Administration. — The fluid extract {extractum cocas fluidum), 
dose, foss— ij ; it is objectionable by reason of not mixing well with 
water. The wine is the best preparation ; dose, f5j-iv. 

V. Cocaine (C 17 H 2l N0 4 ). — This alkaloid has attracted much atten- 
tion from its power of producing local anaesthesia, which property, 
though first discovered by Professor von Anrep,f of Charkov, did not 
attract general attention until the publication of a paper on the subject 
by Dr. Karl Koller, in September, 1884. The hydrochlorate {cocaines 
hydrochloras, C 17 H 21 N0 4 HC1), which is the salt in medicinal use, and 
now official, occurs in white crystals, or crystalline powder, odorless, 
and of a saline, bitter taste, soluble in alcohol and water. The free 
alkaloid is very unstable, and sparingly soluble in water. Solution of 
the hydrochlorate will keep for some time undecomposed, particularly 
if a minute quantity of salicylic acid be added to it. 

Test. — The Cocaine salts can be distinguished from the other 
alkaloids by adding chlorine water (2-3 c. c.) and 2 or 3 drops of pal- 
ladium chloride, which throws down a fine red precipitate dissolved by 
sodium thiosulphate. 

* Boston Med. and Surgical Journ., Sept. 7th, 1882. Mason, 
f Pflilger's Archiv., 1879, xxi, p. 38. 



136 MATERIA MEDICA AND THERAPEUTICS. 

Incompatibles. — The alkaline hydrates and carbonates and borax 
throw down white precipitates with solution of cocaine hydrochlorate. 
Boric acid added or as the menstruum prevents the decomposition 
with borax ; with the iodide-compounds, and zinc chloride, it becomes 
milky. 

Aids. — In its cerebral effects by alcohol and the cerebral stimu- 
lants, as cannabis Indica ; its analgesic, by carbolic acid, opium and 
conium. 

Contraindications. — Being mostly eliminated by the kidneys 
chronic disease of these organs with obstruction to the urinary flow 
would be a reason for not giving cocaine in order to avoid toxic cumu- 
lative effects. 

Physiological Effects. — A few drops of a four per cent, solution 
applied to the conjunctiva rapidly produces anaesthesia of that membrane 
and cornea (lasting from 10 to 20 minutes) with contraction of the 
vessels and anaemia of the membrane and dilated pupil,* preceded by 
slight contraction (which is gradual, the maximum being attained at 
the end of an hour); accommodation is said to be but little affected. 
Applied to the mucous membrane of the mouth, nose, larynx and trachea, 
urethra, vagina and rcctitm, it allays irritation, causes a superficial and 
temporary anaesthesia, at the same time diminishing the sensibility of 
the deeper tissues, contracting the vessels, producing anaemia of the 
surface (best seen in the vessels which ramify through the mucous 
membrane covering the turbinated bones in the nose), and lowering the 
reflex sensibility of the part. It is not readily absorbed by the con- 
junctivae unless used in excess, nor ordinarily by the epidermis ; the 
Schneiderian membrane, however, takes it up rapidly, so that its cere- 
bral effects are soon obtained by this route. Instilled into the external 
auditory meatus it causes a superficial diminution of sensibility without 
affecting the hearing, and lowers the temperature of this region. A 
ten per cent, solution applied to a mixed nerve paralyzes equally the 
motor and sensory strands (Mosso f). 

The account here given of the internal action of cocaine is based 
chiefly on Mosso's \ elaborate investigations upon dogs. Its taste is 
bitterish, and it produces upon the lips, tongue, and fauces a benumb- 
ing sensation, lasting some minutes. Medicinal doses within the 

* " The Influence of Cocaine on the Pupil and Cornea." By Edward Jackson, M.D., 
Trans. Coll. of Phys., 1887, p. 165. 

t Pfluger's Arch., 1890, H'ft., II and 12, pp.553-601, 1890. 
X Arch.ficr experiment. Pathol, u. Pharm., xviii, 1887, p. 153. 



ANTISPASMODICS. 137 

stomach exert no obvious effect upon that organ. When taken in full 
or continued doses, anorexia, insomnia, debility and mental depression 
are the usual sequelae, a group of phenomena, which, when associated 
with the daily use of the drug, give evidence of the cocaine-habit. 
Cocaine induces increased metabolism throughout the economy as 
shown by elevated temperature, rapid pulse and tissue waste, with urates 
in the urine, these changes varying relatively with the amount ingested. 
Secretions: Vulpian (loc. cit.) could detect no increase in the hepatic, 
pancreatic, or salivary secretion, nor augmented flow through the 
ureters, but an augmentation in the sub-maxillary discharge was noted. 
As to the diuretic action of cocaine, Da Costa and C. B. Penrose * ob- 
served a decided increase in the quantity of urine and urates in nine- 
teen out of twenty cases, with slight variations in sp. gr. They attribu- 
ted its diuretic action to raised arterial tension. Nervous system : in 
medicinal doses (in man) it stimulates the functional activity of the 
brain, the intellectual faculties becoming more active and imaginative, 
while the entire economy experiences a general feeling of renewed 
vigor. This state is succeeded by one of depression, and at the end by 
narcosis. Toxic amounts given to dogs induce symptoms of general 
paralysis, abolition of sensibility, cessation of reflex action, cardiac 
weakness and stoppage of respiration. The irritability of the sensory 
nerves is destroyed, and, according to Ott, that of the motor nerves is 
much depressed. Cocaine does not induce paralysis of the sensory 
nerve-endings, as is the case with creasote, the loss of sensation 
caused by it being due to an action on the cells of the spinal cord 
(Mosso, loc. cit.). Intravenous injections,f in dogs, caused general 
convulsions from irritation of the medulla, dyspnoea, reddening and 
swelling of the exposed brain, and diminution in the excitability of the 
psycho-motor centres ; the convulsive attacks were intermittent. Circu- 
lation : Cocaine increases the frequency and strength of the cardiac 
contractions, which are not dependent on paralysis of the vagi (Mosso). 
Anrep states, however, that the vagi are paralyzed, so that the matter 
cannot be considered as yet settled. A reduction of blood-pressure 
succeeds full doses, which is followed by a rise, apparently due to a 
direct action on the vessels. The heart continues to beat after breath- 

*The Med. News, June, 1886. Observations on the diuretic influence of cocaine. On 
the toxicology of cocaine, see Med. and Surg. Reporter, 1891 ; and Maryland, Med. 
Journ , June, 1890, Mattison. 

f These pour le Doctorate en Medicine, Paris, 1887, par Y.Duchesne; and Lancet, 
London, Sept. 19, 1891. 



13S MATERIA MEDICA AND THERAPEUTICS. 

ing has ceased. It stops the frog's heart in systole. Medium doses 
exert no influence on the vaso-motor centre or tonicity of the vessels. 
Respiration is increased, not by a reflex act, but by stimulation of the 
respiratory centre. A poisonous dose destroys life by paralysis of this 
centre. Skeletal muscles : it induces, in full doses, muscular contrac- 
tions of the trunk and extremities by excitement of the motor tracts 
of the cord, the cranial ganglia not being involved. Section of the 
cord between the occiput and atlas does not prevent this. Minute 
amounts act as a muscular stimulant; large, as a paralyzer. A charac- 
teristic symptom of large doses is the production of sudden convulsions 
(not reflex) which resemble those of strychnia-poisoning. On the in- 
voluntary muscles cocaine sets up also contractions, and, if the dose 
be large enough, the urine and faeces will be discharged involuntarily. 
According to Mosso the effects just noted are due altogether to an 
action on the nerve-centres, and not to one upon the muscle-substance, 
as is affirmed by Ott and others. Vulpian * found that cocaine caused 
wide pupillary dilatation. The patellar reflex is at first heightened and 
afterward abolished. 

Temperature : Grains ij injected into the jugular vein of a dog 
caused the rectal temperature to advance about i°, which in toxic 
amounts is followed by a fall. Elimination takes place in part, by the 
kidneys, since it can be detected in the urine. When administered 
hypo dermic ally it causes no irritation. If the injection be made into 
the superficial tissues it acts as a local anaesthetic, while a deep injection 
produces a slight, transitory, general lowering of sensibility, a rise in 
temperature of from o.5°-i.5° F., lasting several hours, dilated pupils 
with uncertain vision, and a stronger and fuller pulse, with increased 
power of the cardiac systole and lowering of the arterial tension. 

Toxicology. — Numerous fatal cases have been reported both by 
injection and perorem, in which the fatal quantity varied so widely 
that the lethal dose cannot be accurately stated. It may be well, how- 
ever, to cite such cases as death from the urethral injection of foj of a' 
20 per cent., and f5j of a 4 per cent., solution; moreover, gr. xxij and 
xx by the stomach have destroyed adult life. The largest non-fatal 
injected dose is gr. xix ; the smallest fatal dose hypodermically is gtt. 
viij of a 4 per cent, solution. The autopsies showed congestion of the 
brain, lungs, liver and kidneys. 

Antidotes. — The poisonous effects of cocaine are antagonized by 

*Compt. Rendu, p. 836, 1884. 



ANTISPASMODICS. J 39 

chloroform and ether, which tend to arrest the tetanus of the respira- 
tory muscles. Amyl nitrite also has been used successfully to antago- 
nize toxic doses of cocaine. After the immediate danger is passed 
chloral should be given, and to restore the breathing, artificial respira- 
tion practised. 

Medicinal Uses. — It has been given internally in gastro-intestinal 
neuroses, as gastrodynia, etc., in doses of gr. \-\ once or twice a day, 
in pill ; and as a cardiac tonic in weak heart and nervous palpitation. 
Prof. Da Costa * has called attention to the successful use of cocaine 
hydrochlorate as a heart-sustaining agent in low fevers, especially 
where there is cerebral disturbance added. He gave gr. T V-J every 
two hours. Cocaine is, however, chiefly employed topically as an anal- 
gesic to prevent pain ia operations on the eye, nose, larynx, vagina, 
rectum, etc. For this purpose the part is painted or sprayed with a 
2-4 per cent, solution, and the application is renewed whenever the 
effect begins to wear off. To diminish sensation in cases of photopho- 
bia, earache, acute myringitis, painful deglutition (from tubercular or can- 
cerous deposits in the pharynx or larynx, or in rabies}, in vaginismus 
(to relieve the pain in order that an examination may be made, or pre- 
vious to the sexual act), and in spasm or pain of the rectum or anus 
due to anal fissure, or in haemorrhoids, it may be used with great benefit 
The anal fistulous tracts maybe packed with lint soaked in a 2 per cent, 
solution, or the same strength may be painted on piles. In acute gonor- 
rhoea, f5ij of a 4-10 percent, solution may be injected into the urethra, 
a few minutes before urination, to prevent pain during that act. In 
irritable stricture, or irritability of the bladder with spasm of the 
sphincter vesicae, a small gelatin-bougie, containing gr. y^ of cocaine, 
is passed down to the neck of the bladder and allowed to dissolve pre- 
vious to a careful exploration of the urethra and bladder. A 20 per 
cent, solution affords relief in supra-orbital neuralgia, pruritus ani, 
and the itching of eczema, and it has been employed for the relief 
of pain during the operation for phimosis. It is also applied to 
painful ulcers and felons, either in powder or solution. The oleate gr. 
vj-viij, diluted with lanolin 5iij, and olive oil f5j, is used as an antipru- 
ritic in pruritus ani and vulvce. 

It is also employed to produce contraction of the vessels and 
diminution of swelling in the mucous membrane of the nose and larynx, 
thus allowing the operator to obtain a better view of the parts during 

* Phila. Med. News, Feb. 5th, 1887, p. 302. 



140 MATERIA MEDIC A AND THERAPEUTICS. 

an operation, or as a means of preventing copious haemorrhage during 
operations on the nasal mucous membrane, or to check epistaxis. 

Solution of cocaine hydrochlorate (4 per cent.) is a safe mydriatic 
under which to make an ophthalmoscopic examination, impairing but 
slightly accommodation, and in a few hours leaving no trace of its 
action. The effect on the pupil can be neutralized by eserine, gr. yfa in 
water foij. The employment of cocaine is almost restricted to render- 
ing the structures of the eye insensible to pain during operation, par- 
ticularly in cataract and iridectomy. It is, however, sometimes added 
to antiseptic and irritant collyria, and also to eye-washes in conjunc- 
tivitis : R Acid boracici, gr. x ; cocainse hydrochloratis, gr. iij ; aquae 
rosae, foj. M. S. — Drop into eye three or four times daily. For 
ophthalmic purposes, it may be had in disks, gr. bh to 2V. 

Topically it is applied within the nose by brush or spray, to control 
/ hay fever, acute nasal catarrh, etc., and to lessen cough in laryngeal af- 
fections. Solution of cocaine hydrochlorate, 4-8 per cent., introduced 
within the nasal cavities by the atomizer, is the best remedy to relieve 
temporarily the occlusion of the nasal fossae in acute and chronic nasal 
catarrh. Collections of inspissated mucus should be first washed 
away with Dobell's solution. In an elaborate article by Hern* on the 
use of cocaine in dental surgery, the following conclusions are reached, 
viz., that it cannot be relied on for the relief of pain after extraction, 
or to deaden the sensibility of dentine, and as an analgesic to exposed 
pulps it is of doubtful utility. As a submucous injection for the pur- 
pose of extraction it is inferior to nitrous oxide gas (summary of 90 
cases). He considers it chiefly useful in the opening of abscesses, in 
the manipulation of models and instruments, and in operations on 
teeth with acute periostitis. Darierf states that it dilates the pupil with- 
out paralysis of accommodation, and that it is quite equal to atropine 
for the purpose of examining the fundus oculi. 

Hypodermic ally it is employed to relieve pain in severe facial 
and other 7teuralgias, in acute pleurisy, prior to the accumulation of 
fluid, and before the performance of minor surgical operations, as the 
opening of abscesses, inflamed- burscE, etc. 

When used for these purposes the needle of the syringe should 
not be inserted deeply, since superficial injections accomplish the real 
object, viz. : local anaesthesia ; when thrown in deeply there is no loss 

* Trans, of the Odontological Society of Great Britain, 1886-7, p. 218. Cocaine and 
its uses as a local anaesthetic in dental surgery. 

f Bulletin Gen. de Therapeutique, cvii. De Pemploi de cocaine en Therap. oculaire. 



ANTISPASMODICS. 141 

of sensation of the superficies (DaCosta*). Reclus,f basing his state- 
ment on 700 cases, directs, as a matter of safety, the injections to be 
made slowly with gradual withdrawal of the syringe as the fluid is 
forced out. Dumont and Barton advise, when cocaine is injected into 
the limbs for local anaesthesia, the application of an Esmarch's band- 
age by the manipulating of which the medicament may be allowed to 
enter the circulation slowly. Deep injections have been especially 
recommended when it is desirable to obtain promptly the stimulating 
effects which the drug exerts over the heart, as in collapse, the early 
stages of shock, weak lieart and low fevers. 

Administration. — Dose, internally, gr. %-ss ; hypodermically, 
gi". yi~y^. Solutions for topical purposes are made from 4 to 20 per 
cent, in water. An ointment is used gr. v to the ounce. 

VI. G-uarana. — This occurs in chocolate-colored cylinders, or as 
a dried paste, which are worked up from the crushed or pounded seeds 
of Paullinia sorbilis and P. cupana (Nat. Ord. Sapindacese), a plant of 
Brazil, where it is used to make a common and highly-esteemed bev- 
erage. It contains more caffeine than any other vegetable substance, 
and also a variety of tannic acid. It is recommended, medicinally, as 
a tonic, astringent, and antispasmodic, and has been found especially 
useful in migraine. 

Administration. — Dose, 5j-ij, or an alcoholic extract may be 
given in doses of gr. x-xx. A tincture and fluid extract (extr actum 
guarance fluiduin) may be prescribed. The latter is official and can 
be given in doses of ttl x-xx, or more ; an elixir is employed as a 
flavoring vehicle. 

VII. Mate (not official). — Under this name the dried leaves of Ilex 
Paraguaiensis, a shrub of Paraguay, are extensively used in preparing 
a beverage throughout that region of country. Paraguay tea, as it is 
termed, has a balsamic odor and bitter taste, and contains a principle 
identical with caffeine and theine, and also tannic acid. 

MOSCHUS— MUSK. 
Class, Mammalia ; Order, Ruminantia. 

Description and Varieties. — Musk is a peculiar dried secretion 
obtained from Moschus moschiferus, the Musk Deer, an animal rather 
larger than the goat, and resembling the deer in its characters, which 

* Trans. Coll. of Physicians, 1886, 39. Hypodermic use of hydrochlorate of cocaine, 
f Gazette Hebdom., Paris 25 ser., 1890, xxvii. 



142 MATERIA MEDICA AND THERAPEUTICS. 

inhabits the mountainous portions of central Asia. The musk-bag is 
found only in the male, and lies between the umbilicus and prepuce. 
It is an oval pod, about two and a half inches long and one and a half 
broad, flat on one side and convex and hairy on the other, and in a 
full-grown animal contains from fSjss to 5vj of a liquid secretion, which, 
when dried, is musk. Two kinds are known in commerce, the China 
and the Russia musk, the former of which is much the stronger. 

Properties and Chemical Constituents. — Musk occurs in grains 
or lumps concreted together, of a reddish-brown color, and has usu- 
ally some hairs of the pod mixed with it. It has a powerful, diffusive, 
aromatic odor and a bitterish taste. It is inflammable, leaving a light 
spongy charcoal. On analysis, it yields ammonia, fat, cholesterin, gela- 
tinous and albuminous principles, but the odorous principle has not 
been isolated. It is partially soluble in water and alcohol, and com- 
pletely so in ether. 

Owing to its high price, musk is greatly sophisticated. Some- 
times artificial pods are met with, which may be distinguished from 
the genuine by the absence of the remains of the penis, and of an 
aperture in the middle of the hairy coat. The musk itself is more 
frequently adulterated by mixture with dried blood and a variety of 
substances. Indeed, little if any genuine musk is found in the shops. 

Effects and Uses. — Musk is a powerful excitant and antispas- 
modic, without much effect on the cerebral functions. But it is now 
little prescribed, owing to the difficulty of procuring it pure. 

Administration. — It may be given in the form of bolus or emul- 
sion. Dose, gr. x, to be repeated every two or three hours. A tinc- 
ture (tinctura moschi) is official, dose, f3j. 

OLEUM .ETHEREUM ETHEREAL OIL. 

Preparation and Properties. — This substance, known also as 
oil of wine, is made by the distillation of alcohol with a large excess 
of sulphuric acid ; it is afterward mixed with an equal volume of 
stronger ether. It is a transparent, nearly colorless, volatile liquid, of 
a peculiar aromatic ethereal odor and sharp bitter taste, sparingly solu- 
ble in water, but readily dissolved by alcohol or ether. Specific 
gravity, 0.910. It has antispasmodic properties, but is used in medi- 
cine only as an ingredient of the compound spirit of ether. 

SPIRITUS ^THERIS COMPOSITUS COMPOUND SPIRIT OF ETHER. 

Preparation and Properties. — This preparation, known as 
Hoffman's Anodyne, is a solution of ethereal oil (25 parts), in stronger 



TONICS. 143 

ether (35 parts) and alcohol (65 parts). It is a colorless, volatile, in- 
flammable liquid, having an aromatic ethereal odor. It becomes milky 
on being mixed with water, owing to the precipitation of the ethereal oil. 

Effects and Uses. — Hoffman's Anodyne has a burning, slightly 
sweetish taste. It possesses the antispasmodic and stimulant effects 
of ether, and derives additional tranquillizing and anodyne properties 
from the ethereal oil present ; it is also an efficient carminative. It 
will often relieve the pain of gastrodynia. It is much used in hysteria, 
and is often added to laudanum to prevent the nausea which the latter 
sometimes excites. A good fever and tranquillizing draught, useful 
in fever y measles and mumps, is : R Spiritus aetheris compositi, f5j ; 
liquoris ammonii acetatis, tincturae opii camphoratae, aa f§ss ; aquae, 
ad f5jss. M. S. — One dose. Shake before using. 

Administration. — Dose, f5j-ij, in sweetened water. 

ORDER IV. TONICS. 

Tonics, called also corroborants, are medicines which produce a 
gradual and permanent increase of nervous vigor. It is only, how- 
ever, in certain conditions of disease that they manifest this invigora- 
ting influence ; as, in a state of health, they often act as irritants or 
even nauseants. Their local effects are similar to their general effects. 
They exalt the nervous functions of the parts to which they are ap- 
plied, and increase their firmness and density. When taken into the 
stomach they produce a twofold corroborant effect, improving the 
digestive powers by their local action, the increased production of 
gastric juice, and strengthening the system generally by their cerebro- 
spinal influence. When given in very large doses, they give rise to 
nausea and vomiting, and when their administration is too long con- 
tinued, they over-stimulate the gastric mucous follicles, causing a path- 
ological secretion to be poured out, and thus produce gastric catarrh. 
The after effect of tonics in large doses, especially of quinine, is one 
of depression upon the nervous centres." 

Tonics differ from stimulants only in the more permanent char- 
acter of their effects. The more powerful tonics are closely allied to 
the narcotics in their action, producing, in over-doses, giddiness, loss 
of sight and hearing, convulsions, delirium, and even death. And 
this analogy is further illustrated by the curative power of tonics in 
the relief of painful and spasmodic diseases, as neuralgia, rheumatism, 
chorea, and epilepsy. 

The articles of this class may be divided into vegetable and mineral 



144 MATERIA MEDICA AND THERAPEUTICS. 

tonics. The vegetable tonics are characterized by bitterness ; and it is 
said that they owe their bitterness and medicinal activity to a principle 
which has been termed bitter -extractive, or by some writers bitter-prin- 
ciple. Tonics should be given before meals. The mineral tonics unite 
astringent with tonic properties. 

The therapeutic application of tonics comprises a diversified 
range of diseases. They are employed as stomachics in dyspepsia, and 
as general corroborants in convalescence from acute diseases, in 
chronic affections accompanied by marasmus and cachexia, in exhaus- 
tion and asthenia, in spinal irritation, hypochondriasis, spermatorrhoea, 
typhus and gangre?ie, and in typhoid conditions of the system generally. 
But their most striking and valuable powers are shown in their febri- 
fuge and antagonistic influence upon miasmatic diseases, cinchona 
bark standing at the head of the list in this respect. The modus 
operandi here is obscure, but the curative powers are undoubted, and 
are generally attributed to their poisonous effects upon protoplasm, 
thus destroying the germs on which these diseases depend. The anti- 
neuralgic and antispasmodic properties of tonics have been already 
alluded to. They also enjoy considerable reputation in the treatment 
of chronic bowel-complaints, where they act by restoring tone to the 
debilitated intestinal tube; and, on the other hand, they are often 
useful as laxatives in torpid conditions of the alimentary canal. 

vegetable tonics. 

The vegetable tonics may be arranged into three sections, viz. : 
I. The Pure Bitters. 2. The Aromatic Bitters, which contain a 
stimulant volatile oil, and are aromatic as well as tonic. 3. The As- 
tringent Bitters, which contain tannic and gallic acids, and are both 
astringent and tonic ; this group contains cinchona, the most powerful 
and important of the vegetable tonics. The bitter-principle is also 
found in many medicines belonging to other classes, as^rhubarb, aloes, 
taraxacum, etc., and imparts to them tonic properties. 

PURE BITTERS. 
quassia. 

Description and Habitat. — Quassia is the wood of Picraenaex- 
celsa (Nat Ord. Simarubeae), a lofty tree of Jamaica and other West 
India Islands. It is imported from the West Indies in billets of various 
sizes, which are found in the shops in the form of chips or raspings. 

Properties and Chemical Constituents. — It has no odor. Water 



TONICS. 145 

and alcohol extract its virtues, which depend on a neutral bitter-prin- 
ciple termed quassin (C 41 H 42 9 ). 

Effects and Uses. — Quassia has an intensely permanent bitter 
taste. It is a mild tonic, free from irritant or astringent effects, and is 
employed principally in dyspepsia, want of appetite, and other stomachic 
affections. It promotes the appetite and digestion and causes a rapid 
development of strength. In diarrhoea from relaxation of the muscles, 
its use is of advantage. It increases * the saliva, milk, and the secre- 
tions from the mucous membranes. It is much used to give additional 
bitterness to malt liquors. It has proved a useful tonic in asthenia, 
atonic dyspepsia, chronic gastritis, anorexia, chlorosis, and lingering 
convalescence especially after fevers. 

Administration. — Dose, in powder (rarely used), gr. xx to 5j ; 
but the best form of administration is that of infusion, in doses of fojss 
to iij ; the infusion is a good remedy for thread-worms, given by enema, 
or the extract gr.j-iij in suppository at night. An extract (extr actum 
quassia?) (aqueous) is given in the dose of gr.v, but it is principally used 
as an excipient. A fluid extract {extr actum quassia? fluidum) is also 
official, dose TTtv-xx. Of the tincture (tinctura quassia?), ioo parts 
contain 10 parts of the powder, the dose is f5j to ij. 

GENTIANA-GENTIAN. 

Description, Habitat and Properties. — Gentian is the root of 
Gentiana lutea or Yellow Gentian {Nat. Ord. Gentianaceae) a perennial 
plant of the mountainous parts of central and southern Europe, grow- 
ing to the height of two or three feet, with broad, ovate, opposite 
leaves and handsome whorled yellow flowers. It is imported in cyl- 
indrical, branched, twisted pieces, of various sizes, marked by trans- 
verse annular wrinkles and longitudinal furrows. Its odor in the fresh 
state is peculiar and disagreeable, but, when dried, feeble. Water and 
alcohol extract its virtues. 

Chemical Constituents. — It contains a fixed oil, an acid [gentisin 
or gentisic acid, Ci 4 H 10 O 5 ), pectin, grape-sugar and a bitter-principle 
termed gentiopicrin (C 20 H 30 O 12 ), a glucoside, which is soluble in water 
and spirit of wine. Other species of gentian are employed as substi- 
tutes for the yellow gentian. The root contains no tannic matters 
(Maisch). 

Effects and Uses. — Its taste is slightly sweetish and intensely 
bitter. Gentian is a pure bitter, without either astringency or much 

* Am. J. Phar., 1883, p. 472. 
10 



146 MATERIA MEDICA AND THERAPEUTICS. 

aroma. In full doses it is more disposed to relax the bowels than the 
other simple bitters ; and, like others of the vegetable tonics, in exces- 
sive doses it is capable of producing narcotic effects. It is an admira- 
ble stomachic in anorexia, chronic gastritis, in all kinds of dyspepsia 
and convalescence, and is also used in the various forms of constitu- 
tional debility. In gastric dyspepsia, due to deficiency in the quantity 
of the gastric juice, gentian combined with an alkali will relieve the 
condition: 1^ Tincturae gentianae composite, f 5j ; liquoris potassae, 
111 xv. M. S. — In a wine-glass of water before meals. 

Administration. — In the form of powder, rarely given on account 
of its bitterness, the dose is gr. x to 5ss. Compound tincture {tinctura 
gentiancE composita, gentian 8 parts, bitter orange-peel 4 parts, carda- 
mom 2 parts, to diluted alcohol enough to make the tincture weigh 
ioo parts), dose, f5j to ij ; extract (extr actum gentiance) (aqueous), 
dose, gr. x to 5ss; and fluid extract {extr actum gentiance fltiidum), 
dose, f5ss-j. An elixir, simple or with tinct. ferric chloride can be 
had in the shops. The compound infusion, though not official, is 
much prescribed, dose f5ij-f5j. Gentian is often well combined with 
other bitters, as calumba, cinchona, and the alkalies. 

CALUMBA-COLUMBO. 

Description, Habitat and Properties. — Calumba is now gen- 
erally ascribed by botanists to Jateorrhiza Calumba (Nat. Ord. Menis- 




JATEORRHIZA CALUMBA. 

permaceae), designated by some writers still under the old name ol 
cocculus palmatus, a climbing plant of Mozambique, on the south- 
eastern coast of Africa. The root is the official portion, and is 
known in Africa under the name of Calumb. It consists of fleshy 
tubers, with numerous offsets, which are the portions used, the main 



TONICS. 147 

root being too fibrous. They are found in the shops in thin, circular 
disks about 2 in. in diameter, externally of a brown, wrinkled appear- 
ance, and internally yellow. The odor is slightly aromatic. Owing 
to the starch which is found in columbo, it is liable to be worm-eaten. 

Chemical Constituents. — It contains, besides a large proportion 
of starch, two bitter-principles, columbin (C 42 H 44 14 ) and berberine 
(C 20 H 17 NO 4 see below), columbic acid (C 22 H 24 7 ), but no tannin. Water 
and alcohol take up its virtues ; and from its liability to attract moist- 
ure from the air, it should not be kept in the form of powder. 

Effects and Uses. — The taste is persistently bitter. Calumba 
is a very agreeable demulcent tonic, particularly acceptable to the 
stomach, and hence well adapted to the convalescent stages of acute 
disorders of the bowels, and of fevers, and to restore the appetite in 
anorexia. It is also a good preparation in the vomiting of pregnant 
women, and is one of the best of the stomachics in all cases where 
there is unusual delicacy of the stomach. In its native country it is 
much employed in the treatment of dysentery. 

Administration. — The dose of the powder is gr. x-xxx (rarely 
used). It may be given in the form of infusion (dose, f§j to ij), which 
should be used at once, as it is liable to spoil. Of the tincture {tinc- 
tnra calumbce) (10 parts to ioo parts of tincture), f3j to jv may be given. 
Of the fluid extract (extractum calumbce fluidum), the dose is f5ss-j. 
Calumba is often combined with the aromatics, alkalies and iron, 
and is sometimes added to purgative mixtures. 

Berberine, (C 20 H 17 NO 4 ) (not official), the alkaloid found in Calumba, 
is widely diffused in the vegetable kingdom, and is obtained from 
numerous plants of the natural orders, Berberacece, Menispermacece, and 
Ranunculacece, as barberry, Hydrastis (q. v.), gold-thread, etc. 

Properties. — It occurs in yellow silky needles, of a bitter taste, 
slightly soluble in water and alcohol. With acids it combines to form 
salts. 

Physiological Effects. — The action of berberine has not yet been 
completely determined. ShurinofT* has, however, obtained the follow- 
ing facts by experimental investigation, viz. : that it paralyzes the pneu- 
mogastrics, coincident with which there is at first an acceleration of the 
cardiac beats, followed mostly by slowing. The arterial tension is 
lowered, due probably to feeble heart-power ; the respiratory centre 
excited ; intestinal peristalsis provoked, and general sensibility dimin- 
ished. It passes off by the kidneys. 

* These de San Petersbourg, 1885, quoted. 



148 MATERIA MEDIC A AND THERAPEUTICS. 

Medicinal Uses. — It has been prescribed in the form of hydro- 
chlorate and sulphate, as a tonic and febrifuge ', in doses of gr. j-x. 

CHIRATA. 

Description and Habitat. — Swertia Chirata {Nat. Ord. Gentian- 
acese), an East Indian plant, has been introduced into European and 
American practice under the name of Chirata, where it now ranks 
among the best pure bitters. The entire plant is official. 

Chemical Constituents. — Chirata contains a peculiar neutral 
bitter-principle, termed chiratin (C 26 H 48 15 ), and ophelic acid (Ci 3 H 20 O 10 ). 

Effects and Uses. — In medicinal properties it resembles gentian, 
and may be used in the same way, particularly in anorexia and con- 
valescence. 

Administration. — Dose of the fluid extract (extractum chiratce 
fluid uni), TTlv-xx; of the tincture {tinctura chiratce), TTLv-f5j. 

AROMATIC BITTERS. 
SERPENTARIA— VIRGINIA SNAKEROOT. 

Description, Habitat and Varieties. — The rhizome and roots 
of several species of Aristolochia are known under the name of Vir- 
ginia Snakeroot. The most familar is A. serpentaria {Nat. Ord. Aristo- 
lochiaceae), an herbaceous indigenous plant, with a perennial root, 
composed of numerous slender fibres, arising from a knotty, brown 
head. A. reticulata is a variety found in the southwestern States. 

Properties and Constituents. — Virginia snakeroot is found in 
the shops in tufts of long, slender, matted fibres, attached to a knotty, 
rugged head. They are brittle, and of a yellowish-brown color. The 
odor is aromatic and camphoraceous. Water and alcohol extract its 
virtues, which depend on the presence of a volatile oil, a bitter-principle ■, 
resins and tannin. The roots of A. reticulata are very commonly sub- 
stituted for those of A. serpentaria, from which they differ only in the « 
larger size of their fibres. They are quite equal to the latter, and are 
thought even to contain a larger proportion of volatile oil. 

Effects and Uses. — Virginia snakeroot possesses a somewhat 
bitter, pungent and aromatic taste. It is a combined stimulant and tonic 
with diuretic or diaphoretic properties, according to the mode of its 
administration. In full doses it irritates the alimentary canal, causing 
nausea, eructations and colic. It is much used in the latter stages of 
fevers, and in other acute diseases, in anorexia, and is frequently com- 
bined with Peruvian bark in the treatment of inter mittents. 



TONICS. 149 

Administration. — It may be administered in infusion (not 
official), dose, f§j to ij, repeated. Of the tincture (tinctura serpen- 
taricE) (10 parts in ioo parts of tincture) the dose is f5j to ij ; of the 

Fig. 12. 




SERPENTARIA : RHIZOME AND ROOTLETS. 

fluid extract (extraction serpentarice fluidum), f5ss— j. Huxhams Tincture 
contains serpentaria. 

EUCALYPTUS. 

Description and Habitat. — The leaves of the Eucalyptus 
globulus (Nat. Ord. Myrtaceae), a lofty tree of Australia, commonly 
known as the Blue Gum-Tree, are classed among the aromatic bitters. 
The leaves should be collected from rather old trees. When fresh 
they are more active than when dried. 

Chemical Constituents. — They owe their activity to a volatile 
oil, which has a characteristic, aromatic, somewhat camphoraceous 



150 MATERIA MEDIC A AND THERAPEUTICS. 

odor, and contains pinene (C 10 H 16 ), eucalyptol or cineol (C 10 H 18 O), and 
valeric, butyric, and capronic aldehydes. The oils from other species of 
eucalyptus differ widely in their chemical composition. Eucalyptus 
also yields tannin and resin. Eucalyptol official in the U. S. P. of 
1S90, "is a colorless liquid, having a characteristic, aromatic, and dis- 
tinctly camphoraceous odor, and a pungent, spicy and cooling taste." 
It is the essential constituent of oil of eucalyptus. 

Physiological Effects. — The oil possesses a decided destructive 
power upon infusoria (^ less than carbolic acid), and locally is an 
irritant. The general taste of eucalyptus and its preparations is aro- 
matic and camphoraceous. Secretions : the ingestion of the drug 
augments the flow of saliva, promotes the appetite, causes diaphoresis, 
and, by stimulating the intestinal glands to activity, induces soft stools. 
When taken in large quantity, decided epigastric pain ensues. It 
decidedly increases the elimination of urea (Gimbert). Nervous sys- 
tem : large doses in animals produce muscular weakness, loss of reflex 
irritability, and finally death from centric paralysis (cord and medulla). 
These effects are preceded by a period of excitement. In small doses, 
in man, it causes mental activity and a feeling of well-being; large 
doses bring on congestive headache, intoxication, and mental prostra- 
tion. The circulation and respiration are both accelerated by eucalyp- 
tus. It is eliminated by the bronchial mucous membrane, kidneys and 
skin, imparting to the secretions of these organs the odor of the oil. 

Medicinal Uses. — Eucalyptus has been given with contradictory 
results in malarial fevers, in doses varying from 5j-iv of the dried leaves, 
or less of the fresh; but it is unlikely that it will ever supersede quinine 
as an antimiasmatic Oleum eucalypti (eucalyptol) has proved efficient 
in bronchitis and whooping cough, in the dose of gtt.v— x in capsules 
or emulsion. Eucalyptus may be used as atonic in dyspepsia; its em- 
ployment, too, in chronic cystitis is recommended. Indeed, its best effects 
are obtained in chronic affections of the mucous membranes, be they 
pulmonary, gastric, or vesical, and its beneficial influence in these dis- 
eases is due to contact of the oil during elimination with the mucous 
surface. The growth of plantations of eucalyptus in miasmatic dis- 
tricts has been found to diminish the spread of malaria. 

Administration. — The fluid extract {extractum eucalypti fluiduni) 
is official, dose, f 5j in some aromatic water ; of eucalyptol^ TTLv-x, 
and oleum eucalypti, gtt. v-10, both in capsules. 



TONICS. < 151 

ANTHEMIS— CHAMOMILE. 

Description, Habitat and Official Portion. — Anthemis nobilis 
(Nat. Ord. Compositae), is a small, herbaceous, trailing European plant, 
cultivated extensively in both Europe and this country. The flower- 
heads are the portions used. They consist of small spheroids, with 
convex yellow disks, (which contain the aromatic properties), and 
numerous white, spreading rays. 

Properties and Constituents. — Chamomile flowers have an 
aromatic taste, probably due to anthemic acid, and a strong, peculiar 
odor, both of which are imparted to water and alcohol. They contain 
a volatile oil, bitter-principle, a little tannic acid and resin, but no alka- 
loid* has been obtained. 

Effects and Uses. — The taste of chamomile is bitter and aro- 
matic. In small doses it is a mild, agreeable, aromatic tonic, and in 
large doses acts as an emetic. The cold infusion is much employed as 
a stomachic, in dyspepsia with flatulence, and the hot infusion is given 
to aid the operation of emetics. The flowers, boiled in water, form a 
good fomentation to inflamed parts. 

Administration. — The usual form of administration is the infu- 
sion, dose, as a stomachic, f§ij, two or three times a day, cold; as an 
emetic, hot, ad libitum. 

Matricaria. — The flower-heads of Matricaria chamomilla or 
German chamomile (Nat. Ord. Compositae), an annual European plant, 
possess properties very similar to those of chamomile. They contain 
volatile oil, bitter- extractive ■, tannin, and malates. They are not much 
employed in this country. 

EUPATORIUM-THOROUGHWORT. 

Description, Habitat and Official Portion. — Eupatorium 
perfoliatum, or Boneset (Nat. Ord. Compositae), is a very common in- 
digenous plant, growing in wet grounds in every part of the United 
States. It has numerous herbaceous stems, with long, narrow leaves, 
perforated by the stems. The leaves and flowering tops are the 
official portion. 

Properties and Constituents. — They have a faint odor, impart 
their virtues to water or alcohol, and contain a bitter glucoside, called 
enpatorin ; also, gum, tannic acid, and a trace of volatile oil. In the 
leaves are found resin, wax and gallic acid.f 

* Am. J. Pkarm., 1889, p. 69. 

| Am.Journ. of Pharmacy, F. W. Franz, Analysis of the Leaves of E. perfoliatum, Feb., 
1888, p. 77. 



152 



MATERIA MED1CA AND THERAPEUTICS. 



Effects and Uses. — Thoroughwort possesses an astringent, bitter 
taste. It is a stimulant tonic, diaphoretic and expectorant, and in large 
doses proves emetic and laxative. It is a good stomachic in dyspepsia 
and anorexia, and from its combined corroborant, expectorant and 

Fig. 14. 






% 




EUPATORIUM PERFOLIATUM: FLOWERING TOPS. 

diaphoretic properties is an excellent remedy in epidemic influenza, 
and in the latter stages of pneumonia and bronchitis. 

Administration. — It is given in infusion, f§ij of which may be 
taken cold, as a stomachic, three or four times a day, and in freer 
warm draughts as a diaphoretic; but the fluid extract {extraction 
eupatorii fluiduifi) is to be preferred, dose, foj- 

ABSINTHIUM-ABSINTHE, OR WORMWOOD. 

Description and Habitat. — The tops and leaves of Artemisia 
Absinthium, (Nat. Ord. Compositae), a European plant, naturalized in 
New England, are ranked among the aromatic bitters, but are not now 
much employed. 

Chemical Constituents. — Wormwood contains an essential oil, a 
bitter-principle termed absinthin (Q H 58 O 9 ), tannin, etc. 



TONICS. 153 

i Physiological Effects. — According to Magnan,* absinthe given 
to animals in small doses induces brisk muscular contractions, while 
large amounts provoke attacks in which the animal falls in tonic and 
clonic convulsions, with stertorous respiration, and involuntary faecal 
and urinary evacuation. The convulsions are not prevented by depriv- 
ing the animal of its cerebral lobes. He points out, too, that absinthe 
epilepsy " is a kind of intoxication " to which is added the phenome- 
non of epilepsy. The oil possesses powerful stimulant properties, in 
large doses producing epileptiform convulsions, and in lethal quanti- 
ties (f§^) is capable of causing poisonous symptoms. No fatal cases 
have, however, been recorded.f A liqueur termed absinthe, containing 
the oil in question, is much used in France, with highly pernicious effects. 
Administration. — It may be given in infusion. 

CASCARILLA. 

Description, Habitat and Properties. — This is the bark of 
Croton Eluteria (Nat. Ord. Euphorbiaceae), a small tree of the Baha- 
mas and other West India islands. It occurs in the form of small, 
thin, quilled pieces, though sometimes in fragments, having a grayish, 
easily detached corky layer and an inner smooth surface. 

Chemical Constituents. — It yields its properties to alcohol, and 
partially to water, and contains volatile oil, resin, a crystalline bitter 
principle called cascarillin, and some tamiin. 

Effects and Uses. — Its taste is warm and bitter. Cascarilla is a 
very pleasant aromatic bitter, causing neither vomiting nor purging, 
and hence agreeing very well with the stomach, and is useful in 
anorexia. 

Administration. — It may be given in powder in the dose of gr. 
xx to 3ss ; but this is a less agreeable form than the infusion, dose, f§ij. 

eriodictyon. 

Description, Habitat and Properties. — The leaves of Erio- 
dictyon glutinosum {Nat. Ord. Hydrophyllaceae), a plant growing in 
California and New Mexico. They are lanceolate, acute, with a toothed 
margin, the upper surface green, the lower reticulate and minutely 
white-tomentose. The odor is aromatic. 

Chemical Constituents. — The leaves contain volatile oil, a bitter 
re 'Sin , tannic acid and ericoliji (C 34 H 56 2 i). 

*Compt. Rendu, 1869, p. 825. 

I Woodman and Tidy, 1882, p. 268. 



154 MATERIA MEDIC A AND THERAPEUTICS. 

Effects and Uses. — The taste of the leaves is balsamic and 
sweetish, and they have been prescribed as a bitter tonic. 

Administration. — The fluid extract (extr actum eriodyctyi fluidum) 
is official, dose, f3j. v The aromatic syrup is used as a pleasant vehicle. 

ASTRINGENT BITTERS. 
CINCHONA. 

Description, Habitat and Varieties. — The name Cinchona 
(derived from the Countess of Cinchon, wife of a viceroy of Peru) is 
applied to the bark of different species of Cinchona (Nat. Ord. Rubi- 
aceae), large trees which grow in the mountainous regions of the 
western portions of South America, from the 22d° of south to about 
the ioth° of north latitude. Two principal varieties of cinchona are 
known in commerce : Cinchona Flava ( Yellow Bark), now dismissed 
from the U. S. P., called in commerce Calisaya Bark, derived from 
Cinchona Calisaya ; and Cinchona Rubra (Red Bark), derived from 
Cinchona succirubra. The Pharmacopcea now recognizes, however, as 
official the barks of all species of the genus Cinchona which contain 
at least five per cent, of total cinchona alkaloids, and at least two and 
one-half per cent, of quinine. 

Under the title of Carthagena Barks, large quantities of very 
good bark have been imported from New Granada, and are now used 
in the manufacture of quinine, under the name of Colombian barks. 
Their percentage of alkaloids varies greatly. 

Within a few years the cultivation of several varieties of cinchona 
trees has been successfully introduced into India, the islands of Ceylon 
and Java, and also into Jamaica, and the markets are now supplied 
with barks of very good quality from these sources. 

Cinchona is brought to the United States from the Pacific ports 
of South America. It is obtained by stripping the trunks and 
branches of the cinchona trees during the dry season, and is dried 
by exposure to the sun, during which process the smaller pieces usu- 
ally become quilled. 

Properties. — The Red Bark (Cinchona Rubra) (the only official 
Bark in the U. S. P. of 1890) usually comes in large, thick, flat pieces; 
sometimes also in quills from half an inch to tw r o inches in diameter. 
They are covered with a reddish-brown, rugged epidermis, beneath 
which is a dark-red, brittle and compact layer, the interior parts being 
woody and fibrous and of a lively brownish-red color. The taste of 
red bark is bitter and astringent ; its odor not different from that of the 



TONICS. 155 

other barks ; its powder is reddish. It contains considerable quantities 
both of quinine and cinchonine. 

Pale Bark, called in commerce Loxa and Lima Bark y derived 
from C. condaminea and C. micrantha, is no longer official. It comes 
in thin quills of a pale fawn-color. The pale barks contain a much 
larger proportion of cinchoniyie than of quinine ; and, from their yield- 
ing little of the latter alkaloid, have fallen into disuse in the United 
States. 

Chemical Constituents. — The most important constituents of 
cinchona are two alkaloid-principles, termed Quinina {Quinine) and 
Cinchonina {Cinchonine), which exist chiefly in combination with an 
acid called kinic (inert). These alkaloids are found in different propor- 
tions in the different barks, quinine being obtained from the yellow 
bark most abundantly, cinchonine from the pale bark, and the two 
principles in about equal proportions from the red bark. Two other 
valuable alkaloids, quinidine and cinchonidine , are found (also as kinates) 
most abundantly in the pale and Carthagena barks, but to a certain 
extent in all ; also the alkaloids, aricine, paricine, quinamine, and pay- 
tine, have been discovered in cinchona. Other principles found are 
cincho-tannic acid, coloring matter, kinovic acid, starch, fatty matter, 
and a trace of volatile oil. Gum is found in the pale bark, but not in 
the yellow or red bark. By heat, the crystallizable alkaloids are con- 
verted into amorphous modifications, as quinine into quinicine, and 
cinchonine into cinchonicine. 

Preparation, Chemistry and Tests. — Quinme ( Quinina ) is 
obtained by heating the sulphate with an alkaline solution. Quinine 
Sulphas (Quinine Sulphate), (C 20 H 24 N 2 O 2 ) H 2 S0 4 +7H 2 0), (see p. 162, 
for properties, uses, etc.), is prepared by neutralizing the alkaloid with 
H 2 S0 4 and purifying the salt. The alkaloid quinine may be obtained 
in the form of fine crystalline needles of a silky lustre, but usually 
occurs as a loose white powder; it is inodorous, very bitter, and 
alkaline. It is soluble in 1670 parts of cold water, and in 760 parts of 
boiling water, in little more than its weight of absolute alcohol, in 
about 5 parts of chloroform, and in 25 parts of ether, and also in the 
fixed and volatile oils. It unites with acids to form salts, the most 
important of which is the official salt, the sulphate. The composition 
of quinine is C^H^N^+sH^. Quinine and its salts may be distin- 
guished from all other vegetable alkalies and their salts (excepting 
quinidine and quinicine) by forming an emerald-green precipitate 
when treated first with fresh chlorine-water and then with ammonia 



156 MA TERIA MEDICA AND THERAPEUTICS. 

(Thalleioquin test, detects 50V0 part, Fluckiger). Herapattis test is 
made by adding to quinine sulphate (gr. v), diluted acetic acid (f5j), 
with alcohol (f5ss), and tincture of iodine (8 drops), heating gently 
over a spirit-lamp till it forms a clear light-brown solution, when as the 
liquor cools, right-angled, quadrate, rhombic crystals are deposited, 
which by reflected light appear of a copper-green color, resembling 
the elytra of Spanish flies. This precipitate, which is quinine iodo- 
sulphate (C 20 H 24 N 2 O 2 SO 4 H 2 I 2 ), is termed Herapathite. Cinchonine is a 
white crystalline substance, less bitter than quinine, almost insoluble 
in cold water, very soluble in boiling alcohol, and slightly soluble in 
ether and the fixed and volatile oils. Its composition is C 19 H 22 N 2 0. 
It is distinguished from quinine by striking a white precipitate when 
chlorine-water and afterward ammonia are added ; with potassium 
ferrocyanide, a yellowish-white precipitate falls. As cinchonine is but 
slightly soluble in ether, while quinine is soluble in that menstruum, 
the latter may by this means be readily separated from the former 
alkaloid. The medicinal properties of quinine and cinchonine are 
analogous, and cinchonine sulphate is now official. Quinidine- is 
isomeric with quinine, but more crystallizable and less soluble in ether; 
its salts strike a white precipitate with solution of potassium iodide. 
Cinchonidine is isomeric with cinchonine. It is usually found mixed 
with quinidine, the mixture being known as commercial quinidine. The 
commercial quinidine sulphate (which is more soluble in water and 
alcohol than quinine sulphate) may be used as a substitute for the 
latter salt. 

Incompatibles. — The alkalies and alkaline earths precipitate the 
alkaloidal principles of cinchona; tannic acid, and the tincture and 
compound solution of iodine, form with them insoluble compounds ; 
the ferric salts precipitate cincho-tannic acid ; solution of potassium 
arsenite is also incompatible with infusions and decoctions of cinchona, 
as it forms a precipitate with them. 

Aids. — As a tonic such bitters as gentian, quassia, serpentaria, 
and nux vomica. Its antipyretic effect is enhanced by antipyrine, 
antifebrin, resorcin, and salicylic acid. As an antiperiodic eucalyptus, 
carbolic acid, creasote, arsenic, though for this effect it is best given 
alone. Aconite increases its sedative cardiac influence. 

Physiological Effects. — Locally, cinchona and its alkaloids act 
as irritants, and possess, besides, a marked antiseptic power, arresting 
putrefaction and fermentation by a destructive influence upon fungi 



TONICS. 157 

and infusoria.* Sternberg f found that quinine sulphate, I to 880, pre- 
vents the development of bacilli and micrococci. As the physio- 
logical action of cinchona depends on its contained alkaloids (chiefly 
quinine), the following account relates to the latter. The taste of the 
bark is bitter and astringent; that of quinine intensely bitter. The 
cinchona alkaloids are readily dissolved from the bark by contact with 
the gastric juice, and being diffusible and crystalline, quickly osmose 
into the blood ; if, however, from any cause, they pass into the small 
intestines, contact there with the alkaline fluids of that tube will pre- 
cipitate them, and they will be discharged with the faeces. Secretions : 
cinchona stimulates the peptic glands, increasing their secretion and 
consequently the appetite and digestion, and, from the tannic acid 
which it contains, produces a slightly astringent effect not belonging 
to the salts of its alkaloids. If given too long, or if the stomach and 
bowels are in an irritable condition, it is apt to produce nausea, vomit- 
ing, and even diarrhoea. Quinine sulphate and hydrochlorate heighten 
the gastric acidity by the increased formation of ffee HC1, and they 
favor the absorptive function <|f the stomach. Occasionally quinine 
causes a cutaneous eruption, (as erythema, herpes, etc.). A rarer effect 
is renal and cystic irritation. Quinine, it is said, causes contraction of 
the spleen (Piorry) ; this, however, has been denied. Large doses ot 
quinine (gr.xxv-xl) decidedly diminish the amount of urea and uric acid 
in the urine, as well as the phosphoric acid. Nervous system : quinine 
in medicinal doses stimulates the cerebral functions and increases the 
mental activity. Full doses (gr.xv-xx) induce a hyperaemic condition 
of the brain, the first indications of which are felt by the special senses, 
especially that of hearing, which undergoes subjective noises, as ring- 
ing and roaring in the ears (tinnitus aurium), with partial deafness, the 
latter rarely permanent; amblyopia is also a sequela, though much less 
common. Doses of this size, continued, may produce a sense of fullness 
of the head, frontal headache and vertigo. Very large doses augment 
the above symptoms, which are accompanied by a slow, weak pulse, 
dilatation of the pupils, convulsions and stupor ; death in rare cases has 
followed quinine-poisoning, though immense doses of it have been 
taken with impunity. Quinine given to frogs reduces and finally 
abolishes the reflex excitability of the spinal cord. Its effect in this 
respect, on man, is as yet sub judice. Circulation : in small doses 

* Arch, de Physiol. JVorm. et Pathol., v, 1873, P- 389- L'action de la quinine sur les 
vibrioniens et sur les mouvements amibo'ides ; par Bochefontaine. 
f Manual of Bacteriology, p. 186. 



158 MATERIA MEDICA AND THERAPEUTICS. 

quinine slightly accelerates the action of the heart ; while large amounts 
(gr. xl-lx) decidedly retard its beats and force, and sometimes cause 
it to intermit, especially in children. This retardation occurs after 
section of the vagi, indicating a direct influence on its motor ganglia ; 
applied in solution to the cut-out heart it quickly stops its movements. 
Upon the blood, quinine has several marked actions, as follows : both 
in health and inflammation it diminishes the number of white cor- 
puscles, and retards their amoeboid movements (Binz) ; Schwalbe's 
investigations, however, do not confirm those of Binz ; it hinders the 
carrying of oxygen to the tissues, and increases the proportion of red 
to white corpuscles (Cutler and Bradford). The absorption of quinine 
by the blood is aided by the carbon dioxide gas of that fluid. It is 
unknown how it exists there. The production of acid in freshly-drawn 
blood is diminished by the addition of quinine solution (Binz). Uterus : 
when taken in doses of gr. x-xx, during labor, it energizes the uterine 
contractions. Temperature : in small doses in health no influence 
upon the animal heat has been noted ; but in large amounts a moderate 
fall takes place (about y 2 ° F.). No complete explanation has as yet 
been given of this action, but it seems to be due to an interference 
with the oxidation-processes in every part of the body. 

Elimination : * quinine is eliminated chiefly by the kidneys, and 
it has been found in the urine twenty minutes after the subcutaneous 
injection of a large dose. According to Thau from y 2 to y^ escapes 
by this route in the first six hours. It is discharged partly as quinine 
and partly as isomeric modifications (quinicine). 

Medicinal Uses. — Though the medicinal value of cinchona, or 
its alkaloid, quinine can scarcely be over estimated in the treatment of 
various diseases, yet its chief therapeutic applications may be divided 
into three classes, in the following order of merit: I. Antiperiodic; 
2. Antipyretic ; 3. Tonic. The most important therapeutic employ- 
ment of cinchona is as an antiperiodic in the treatment of malarial 
fevers. Its efficacy in these diseases, which must now be regarded as 
of a specific nature, was first made known to the world by the Jesuit 
missionaries in Peru, from whom it was called Jesuifs powder. As 
cinchona itself is now rarely administered internally, the following 
statements apply to its alkaloids, on the presence of which its powers 
depend. The type of miasmatic fever in which the effects of quinine 
are most strikingly displayed is intermittent, the non-pernicious and 

* Bull. Gen. de Therap., t. xci. Rienzi. 



TONICS. 159 

uncomplicated forms of which it rarely, if ever, fails to control. It 
may be given in these cases from the very onset of the attack ; and if, 
owing to gastric irritability, it is rejected by the stomach, it should be 
introduced by the rectum or by hypodermic injection. In remittent 
fever, quinine is scarcely less useful than in intermittent ; and most 
physicians who practise in miasmatic districts now concur in recom- 
mending its early exhibition in these fevers, without waiting for a 
remission. In either disease the best time for its administration is 
between the paroxysms, since it has been shown that the bacillus 
malariae are most sensitive to the action of quinine at this time, and 
should it be desirable to get i'-s effects quickly, on an empty stomach 
and in solution. From 15 to 30 grs. may be given daily for the first 
three days or so. If the onset be accompanied by violent headache 
and bounding pulse, morphia subcutaneously and tincture of aconite 
should be given with it. In the pernicious forms of malarial fevers, 
comatose or algid, the early administration of large doses of quinine 
or cinchonine, in combination with stimulants, is imperatively de- 
manded ; and the hypodermic injection of quinine sulphate (gr. v-xx, 
see p. 161) may even be necessary. As a prophylactic against malarial 
fevers and in the malarial cachexia, the use of the preparations of cin- 
chona is very efficacious. Persons going to a malarious district should 
take at first about gr. x daily. We now seem to be approaching an 
explanation as to the exciting cause of malarial fevers and the specific 
action of quinine against them, due to the researches of Marchiafava* 
and Celli on the plasmodium malariae ; of Laveran,f on the microbes 
found by him in the blood ; of Councilman and Abbot, % on certain 
hyaline bodies discovered by them also in the blood ; and, lastly, to 
Osler,|| on the haematomonas malariae. These observers, with singu- 
lar unanimity, discovered certain microbes in the blood of persons 
suffering with miasmatic fever, the vitality of which was destroyed by 
quinine. These microbes are found associated with all forms of ma- 
larial fever and belong to the protozoa. They destroy the red cor- 
puscles, transforming the haemoglobin into pigment, hence the anaemic 
and muddy complexion observed in malaria. Quinine causes these 
parasites to disappear. So far they have not been found outside the 

*Bull. d. r. Accad. Med. di Roma, 1886, xii, 19-22. Marchiafava E. Richerche sulP. 
infezione malaria. 

f Traite des Fievres Palustres, par A. Laveran, 1884, p. 448. 

% Am. J. M. S., April, 1884, p. 416. 

|| Brit. Med. Jour., March 12, 1887, P- 55^. 



160 MATERIA MEDIC A AND THERAPEUTICS. 

body, nor is it known how they gain access to it. Golgi * has shown 
that during a paroxysm they undergo a process of segmentation. 

The antipyretic power which the quinine salts possess renders their 
use extremely valuable in conditions of fever. In such states quinine 
is best given in a single large dose (5ss to 5j), and since the elimina- 
tion of the major portion of it takes place in the first six hours, it 
may be necessary to repeat this dose at the expiration of that time, if 
it be desirable to sustain its antipyretic effect. In Germany, the treat- 
ment of typhoid fever with large doses of quinine, gr. xx to xl, given in 
the evening, is in vogue. On account of the cardiac weakness, anor- 
exia, and nervous depression produced by the salts of quinine, they 
should not be given in large doses in pneumonia.^ In erysipelas, the 
author has found quinine sulphate scarcely, if at all, less efficient than 
in malarial fevers, and it should be given gr. iij-v, t. d., frequently 
combined with large doses of iron (q. v.). In puerperal septicemia, 
quinine may be given as an antipyretic in addition to antiseptic, uterine 
and vaginal injections, with digitalis, as indicated, and opium, stimu- 
lants and easily assimilated food. In the treatment of after-pains, 
when opium has failed, quinine in doses of gr. x bis die, often gives 
relief. In all conditions of hyperpyrexia, as in the exantliemata, measles 
and scarlet fever, and pycemia, etc., it is still employed, although the 
phenol-derivatives (e. g., antipyrine) are superseding it to reduce tem- 
perature. 

As a general tonic and stomachic in anorexia, asthenia and neuras- 
thenia, cinchona and its alkaloids are also much used, but where 
gastric susceptibility exists, some of the simple bitters may be prefer- 
able. In convalescence from acute diseases, as the continued and 
eruptive fevers, in the hectic of phthisis, and in typhoid conditions gen- 
erally, it is constantly prescribed. In the various neuralgic?, as sciatica, 
facial, and intercostal, a large dose of quinine combined with morphine 
or belladonna, or smaller doses with arsenic and iron, form an effective 
plan of treatment. By its contracting action on the gravid uterus, 
quinine sulphate exerts an influence in promoting normal labor, and 
will often prove useful in counteracting inertia of the uterus in parturi- 
tion. A full dose of quinine will sometimes abort an impending 
paroxysm of asthma. In surgical shock, as after grave operations, the 
administration of quinine is of the greatest utility. There are many 

* Deutsche Med. Wochen., 1892, No. 29 and 30. 

I N. Y. Med. Rec, Jan. 29th, 1887. Discussion on the use of quinine in pneumonia; 
N. Y. Academy of Medicine. 



TONICS. 161 

other maladies, besides, in which cinchona or its alkaloids render im- 
portant aid, viz., to combat the fever and bone-pains of dengue, obstinate 
though they be; m pericarditis before marked effusion has taken place; 
as a tonic in emphysema, influenza and hay-fever ; to relieve headache 
(browache) ; and in the management of exophthalmic goitre, purpura, 
and the onset of yellow fever. Topically, cinchona is employed as an 
astringent and antiseptic. A lotion of quinine sulphate is used in alopecia. 
According to Osier,* in tropical or amoebic dysentery warm enemata of 
quinine, I to 5,000, which destroy the amcebae, are of great benefit. 

Administration. — The use of cinchona in powder has been 
abandoned, owing to its bulk and disagreeable taste. When exhibited 
in this form Iss to jss is the dose as an antiperiodic, given usually in 
divided amounts ; as a tonic, 5j. The following official preparations 
are employed : infusion (infusum cinchonce) (6 parts of the powder to 
water ioo parts, to which aromatic sulphuric acid I part is added), dose, 
f^ij repeated; extract (extr actum cinchonce), dose, gr. x-xxx, equivalent 
to 3j of bark; fluid extract {extr actum cinchonce fluidum), dose, f3j, 
equal to Jj of bark ; tincture (tinctura cinchonce), (20 parts bark to a 
mixture of 73^ parts of glycerin, with sufficient alcohol and water to 
make 100 parts of the tincture), dose, f3j-iv ; compound tincture (tinc- 
tura cinchonce. compositd) \_Huxham's~\ (containing red bark 10, bitter 
orange-peel 8, serpentaria 2, glycerin 7^, alcohol and water to make 
100 parts of tincture), dose, f3j-iv. An elixir of calisaya bark, simple, 
or combined with iron, bismuth, pepsin, strychnine, etc., may be 
used. In prescribing bark, opium or port wine is often given with 
it, when it acts on the bowels. It is also occasionally combined 
with serpentaria, and when the stomach will not retain it, it may be 
administered by the rectum, or the hypodermic exhibition of the quinine 
sulphate may be resorted to. When administered subcutaneously, the 
danger of the formation of a small abscess at the seat of introduction 
must not be lost sight of; the small tumor formed by the fluid should 
be pressed away, and a salt soluble in water selected, as the bisul- 
phate, the solubility of which may be increased by the addition of 
tartaric acid. The buttocks and lumbar region are good sites for the 
injection. The systemic effects of quinine may be obtained by intro- 
ducing it within the rectum in suppository or enema in starch-water; 
but it is advisable only to so use it when its administration by the 
mouth is contraindicated. 



* Practice of Medicine, 1893, p. 139. 
11 



162 MATERIA MEDICA AND THERAPEUTICS. 

Quininae Sulphas {Quinine Sulphate). — This salt occurs in fine, 
silky, rather flexible needle-shaped crystals (interlaced among one 
another, or grouped in small star-like tufts), which are odorless, very 
bitter, and slightly efflorescent It is soluble in 740 parts of cold and 
30 parts of boiling water, readily soluble in alcohol, but insoluble in 
ether. Quinine is a ternary base, and forms, with sulphuric acid, a 
basic, normal and acid sulphate. Basic quinine sulphate, (C 20 H 24 N 2 O 2 ) 2 
H 2 S0 4 + 7H 2 0, is the salt in common use. By the addition of di- 
lute sulphuric acid to the basic salt normal quinine sulphate [quinine 
bisulphate) (QoH^NaOgH^SCXt) 4- 7 aq. is obtained in four-sided prisms, 
which are soluble in 1 to 10 parts of cold water. Acid quinine sul- 
phate (C 20 H 24 N 2 O 2 2H 2 SO 4 ) + 7H 2 + 7 aq.) occurs as white prisms, 
freely soluble in water. Solutions of quinine and its salts possess the 
property of fluorescence and left rotary power on polarized light. 
Various substances are mixed as adulterations with quinine sulphate. 
They may be detected by adverting to their relative solubility in dif- 
ferent menstrua, as compared with the sulphate, or by chemical tests. 
Thus, gum and starch are left behind by alcohol ; salicin becomes red 
on contact with sulphuric acid, etc. 

Incompatibles. — Quinine sulphate is decomposed by the alkalies, 
their carbonates and the alkaline earths. With the alkaline acetates 
and Basham's mixture quinine acetate is formed sparingly soluble. In 
solution it forms white precipitates with liquor potassae, sodae, and 
aqua ammoniae. The tannic acid of astringent infusions throws down 
a white compound, and the soluble lead salts, oxalic, tartaric and gallic 
acids yield a precipitate with it; with compound solutions of iodine, 
quinine iodide is formed. 

Effects and Uses. — The effects of quinine sulphate on the sys- 
tem are analogous to those of cinchona, and, from its being less apt to 
disagree with the stomach, it has almost superseded the use of the 
latter. See cinchona for effects and uses of. 

Administration. — The ordinary dose of the quinine sulphate* is 
as an antipyretic, gr. x-xx, repeated as indicated ; as an a?ztiperiodic, gr. 

* Therapeutical equivalents of the salts of quinine, by M. Boymond. Bull. Gen. de 
Therap., Avril I5ieme, 1887, p. 311. 

1.34 gramme of the basic sulphate = I gramme of anhydrous quinine. 
1. 3 1 " " valerianate = " " " 

1.22 " " hydrochlorate = " " " 

I.30 " " hydrobromate = " " " 

1.69 " " bisulphate = " » " " 

Others also are given. 



TONICS. 163 

xvj, equal to about Ij of bark, but as much as gr. xx, and even more, 
are often required; as a general tonic, gr. j-vj. Children may take as 
follows : 2 to 4 years, gr. iij-vj ; 5 to 10, gr. viij-x ; 1 1 to 15, gr. x-xv. 
It may be given dissolved in some aromatic water by the aid of aro- 
matic sulphuric acid ; also as an enema, suppository or hypodermically. 
Quinine sulphate can be had in the shops in gelatin or sugar-coated 
pills, from gr. j to v in each pill. 

Quininae Bisulphas (Quinine Biszdp hate) (C 20 H 24 lSi 2 O 2 H 2 SO 4 )+7H 2 O, 
the normal quinine sulphate, is preferred only on account of its greater 
solubility (1 part to 10 of water), as it contains about one-third less of 
anhydrous quinine than the basic sulphate. {See foot-note, p. 162.) 
It may be given in the same doses as the ordinary sulphate. 

Many other salts of quinine have been introduced into practice, but 
few possess any advantage over the sulphate and bisulphate. 

Quininae Valerianas {Quinine Valerianate) (C 20 H 24 N 2 O 2 C 5 H l0 O 2 + 
H 2 0), is obtained by dissolving freshly precipitated quinine in diluted 
valerianic acid. It occurs in transparent or white rhomboidal tables, 
of the peculiar repulsive odor of valerianic acid, and an acrid bitter 
taste, soluble in alcohol and ether, and soluble in water (1 to 100). It 
fulfills the indications of quinine and valerianic acid, and is therefore 
especially useful in nervous disorders. Dose, gr. j to xx. Quini?ie 
hydrobr ornate {Quinines hydrobromas) (C 20 H 24 N 2 O 2 HBr + H 2 O) is official, 
and being soluble in 54 parts of water, is recommended also for hypo- 
dermic use (Gubler). Quinine hydrochlorate {Quinines hydrochloras) 
(C 20 H 24 N 2 O 2 HC14- 2H 2 0) is also official; it is soluble in water 1 to 
34 parts. 

Quinine sulphovinate, from its ready solubility, dissolving in twice 
its weight of water, is well adapted to hypodermic injection. 

Quinine carbolate, citrate, phosphate, salicylate, and sulphocar- 
bolate have all been used of late. 

Crude quinine is the impure quinine obtained from the manufac- 
turer before separation from the insoluble impurities. It is a soft solid 
of resinous aspect, nearly free from bitterness, and may be given to 
children in the same doses as the sulphate. 

Cinchoninae Sulphas {Cinchonine Sulphate) [(C 19 H 22 N 2 2 ) 2 H 2 S0 4 + 
2H 2 0)] is made from the mother-water remaining after the crystallization 
of quinine sulphate. Being the most soluble of the sulphates of the 
four alkaloids found in bark, it remains in solution after the quinine 
sulphate and the mixed cinchonidine and quinidine sulphate have crys- 
tallized out. From the mother-water it is precipitated by solution of 



164 MATERIA MEDICA AND THERAPEUTICS. 

soda, then washed with alcohol, next re-converted into a sulphate, and 
boiled with animal charcoal to decolorize it. In occurs in short, 
oblique, shining prisms with dihedral summits, of a very bitter taste, 
more soluble in water (66 parts) than quinine sulphate, readily soluble 
by alcohol, and sparingly so by ether. It rotates polarized light to the 
right. By the addition of sulphuric acid it is converted into the more 
soluble neutral sulphate. It is now admitted to have the same reme- 
dial properties as quinine sulphate, but requires about one-third larger 
doses. Qui?iidine sulphate (Quinidince Sidphas) (C 20 H 24 N 2 O 2 ) 2 H 2 S0 4 
+2H 2 0) (soluble in I to ioo of water), and cinchonidine sulphate* (Cin- 
chonidince Sidphas (C 19 H 22 N 2 2 ) 2 H 2 S0 4 +3H 2 0) (soluble in I to 70 of 
water) are now official. Their effects and uses are similar to those of 
quinine, as a substitute for which they are much used, but the dose is 
somewhat larger. 

Warburg's tincture, which contains aloes, rhubarb, angelica fruit, 
gentian, camphor, cubebs, myrrh, etc., etc., and quinine sulphate gr. x 
in each f§, is very serviceable in malarial fevers, given after an evacua- 
tion of the bowels in the acute stage. 

SALIX WHITE WILLOW. 

Description. — The bark of Salix alba (not official) and other 
species of Salix {Nat. Ord. Salicaceae), is ranked among the astrin- 
gent bitters. 

Chemical Constituents. — It contains salicinum (salicin, d 3 H 18 7 , 
a glucoside) a neutral principle prepared from the bark of Salix Helix 
and other species of Salix, consisting of white, slender, silky crystals, 
inodorous, soluble in water (1 part to 28) and alcohol, but not in ether. 

Effects and Uses. — It has antiseptic and antifermentative prop- 
erties, but is not toxic. Its taste is very bitter. Salicin produces 
effects similar to those of salicylic acid (q. v.), and is employed in the 
same therapeutic range, especially in acute rheumatism. It renders the 
sweat alkaline. 

Administration. — Dose, gr. x-xx, frequently repeated, in pills or 
capsules. 



* In an able article by J. Marty, entitled, " Contribution a l'etude du sulphate de cin- 
chonidine envisage au point de vue physiologique et therapeutique," Bull. Gen. de Therap., 
cvi, pp. 395, 445, 1884, the following conclusions are drawn, viz., that its action varies 
greatly ; that occasionally therapeutic doses may prove toxic ; and that it should be used 
only in mild cases, and in doses double those of quinine. 



TONICS. 165 

PRUNUS VIRGINIANA— WILD CHERRY. 

Description and Official Portion. — The Wild Cherry has long 
been known under the name of Prunus Virginiana. This name, how- 
ever, belongs to another tree, the choke-cherry ; and the wild-cherry 
is now properly distinguished as Prunus serotina {Nat. Ord. Rosacese). 
The official portion is the bark of the root and trunk, the former of 
which is the more active. 

Properties. — It is found in the shops in pieces of various lengths 
and sizes, deprived of the epidermis and slightly curved, of a reddish- 
brown color, and a bitter, slightly astringent aromatic taste. 

Chemical Constituents. — It contains a bitter, amorphous principle* 
(not isolated), resin, starch, tannic and gallic acids, a ferment-principle 
not identical with emulsin, and yields on distillation a volatile oil, con- 
taining hydrocyanic acid, which does not pre-exist in the bark, but is 
formed by the reaction in water of the bitter-principle and the ferment. 
The leaves also yield this oil. Boiling water impairs the virtues of 
the bark. 

Effects and Uses. — Wild-cherry bark is tonic, with some astrin- 
gency, and at the same time exercises a sedative influence on the ner- 
vous and circulatory systems, owing to the hydrocyanic acid which is 
developed in it. It is used with excellent effect as a sedative corrobo- 
rant in the various forms of pulmonary irritation, particularly in the 
latter stages of pneumonia and in the hectic of phthisis. It is also a 
useful stomachic and tonic in a variety of cases. 

Administration. — The infusion {infusum pruni virginianoi) (4 parts 
to cold water enough to make the infusion weigh 100 parts), is given 
in the dose of f§ij, twice or thrice daily. Of the fluid extract {extractum 
pruni virginiana) the dose is f5j-ij. Of the syrup {syrupus pruni vir- 
giniance) an agreeable and efficient preparation in the treatment of 
pulmonary cough, the dose is f§ss. 

DIGESTIVE FERMENTS. 

PEPSINUM— PEPSIN. 

In connection with the subject of stomachic tonics, this article is 
entitled to consideration. By the U. S. P. it is designated as " a pro- 
teolytic ferment or enzyme obtained from the glandular layer of fresh 
stomachs from healthy pigs." 

* Pharma. Rundschau, Sept., 1887, p. 203, "On the Constituents of Wild Cherry 
Bark." Power and Weimer. 



166 MATERIA MEDICA AND THERAPEUTICS. 

Source. — It is prepared from the rennets either of the calf, sheep, 
or pig, taken from the animal as soon as killed, the best process being 
Scheffer's. 

Properties and Action. — It is a fine yellowish-white amorphous 
powder, free from offensive odor, of feebly acid reaction, soluble in ioo 
parts of water with opalescence, its solubility being increased by HC1, 
but insoluble in alcohol. Pepsin, the ferment of the gastric juice, has 
the property, at 104 F. in an acid solution, "of digesting not less 
than 3000 times its own weight of freshly coagulated and disintegrated 
egg-albumen." Saccharated pepsin u should digest 300 times its own 
weight of freshly coagulated and disintegrated egg-albumen," when 
tested by the process for pepsin. Glycerin is the most reliable agent 
for preserving the ferment of pepsin (Liebreich). 

Incompatibles. — The alkalies and mineral salts precipitate pepsin 
from solution : the former may be given with it in the form of powder. 
Since alcohol impairs the digestive property of pepsin, preparations 
of it in wine are unreliable. 

'Aids. — Pancreatin and HC1. 

Medicinal Uses. — Pepsin is a good deal used in dyspepsia, chronic 
gastritis, ancemia and in diarrhoea, especially that which occurs in 
infants or children, where the stools contain undigested food. Acid 
solutions favor its action, especially hydrochloric acid, and it may be 
combined with this acid if deficiency of the gastric juice be suspected, 
as, ^ Essence of pepsin, f§iij ; tr. nux vomicae, foij ; acid, muriatici 
dilut, f5yj. M. S. Teaspoonful t. d. in water. When nourishment is 
to be given by the rectum (as when food is rejected by the stomach), 
the addition of pepsin and a little hydrochloric acid to animal broths 
for rectal injection is highly useful. 

Administration. — Pepsin (pepsinuni) may be given in doses of 
gr. v-xx after each meal, taken on bread, or in compressed pills, or 
in elixir. It may be had combined with strychnine, iron, quinine, 
pancreatin, etc. Peptonizing tablets are obtainable in the shops. Of 
saccharated pepsin (pepsinnm saccliaratuni) the dose is gr.v to xx, dis- 
pensed as for pepsin. 

Ingluvin (not official) is a preparation from the gizzard of the 
domestic fowl ; it is an aid to digestion, its action depending, probably, 
more on the bitter-principle which it contains, and which stimulates the 
gastric glands, than to any digestive action of the preparation itself. It 
is recommended to allay various forms of reflex vomiting, especially the 
vomiting of pregnancy. Dose, gr. v-xv, in pills or capsules. 



TONICS. 167 

FEL BOVIS-OXGALL. 

Source. — The fresh bile of the Bos Taurus (class, Mammalia ; 
order, Ruminantia). 

Properties and Constituents. — This is a greenish, viscid liquid, 
of peculiar, unpleasant odor, and bitter taste. From it are extracted 
the gall-acids (glycoholic, etc.), and gall-pigments (biliverdin, etc.). 

Effects and Uses. — Bile facilitates the absorption of fats, partly 
restrains intestinal putrefactive changes, and stimulates peristalsis. It 
precipitates pepsin, and interferes with the gastric digestion of albu- 
men. Its employment is limited to diseases in which there is a defi- 
ciency of bile, as certain forms oi jaundice and dyspepsia. 

Administration. — Purified oxgall (Fel bovis purification), dose, 

gr. v-x in capsules. 

pancreatinum— pancreatin. 

Source. — Pancreatin is by the U. S. P. designated as li the mixture 
of the enzymes existing in the pancreas of warm-blooded animals." 
This is obtained, by Mattison's process, from the pancreas of recently- 
killed animals. 

Properties. — It occurs as a yellowish-white, or grayish, amor- 
phous powder, almost odorless, and with a faint meat-like taste. It is 
nearly entirely soluble in water, but insoluble in alcohol. About gr. 
v will peptonize milk Oj, to which has been added NaHC0 3 , gr. xx, at 
105 ° F. ; and gr. v of pancreatin will saccharify gr. 100 of starch- 
paste, at 105 ° F., almost at once. 

Incompatibles. — Prolonged contact with the mineral acids. 

Aids. — Pepsin and the alkalies. 

Effects and Uses. — In alkaline solution it digests albuminous 
matters, converting them into peptones, emulsifies fat, and changes 
starch to sugar. Pancreatin is employed to promote the digestion of 
fatty matters, as in the treatment of chronic gastritis, asthenia, ancemia, 
and phthisis. As the activity of pancreatin is destroyed by acid, it should 
be given from 2 to 4 hours after meals. It is a good addition to cod- 
liver oil. 

Administration. — Dose, gr.v-x, in capsules or compressed pills. 

PAPAYA. 

Preparation and Active Principles. — This is the dried juice of 
the half-ripe fruit of the Carica papaya (the Papaw tree of the West 
Indies), (Nat. Ord. Papayaceae), a white, slightly astringent powder, 
soluble in water, containing the ferment papain. It is obtained by 



168 MATERIA MEDICA AND THERAPEUTICS. 

making scratches on the fruit, and scraping off the powder after it has 
dried. 

Incompatibles. — Papain is precipitated by alcohol (tinctures, etc.), 
lead acetate, tannin and H 2 N0 3 . 

Physiological Effects. — This principle has the property of di- 
gesting albuminoids and converting them into soluble peptones. Ac- 
cording to Finkler, its action is that of a ferment, and not one of solu- 
tion ; by Gordon Sharp,* its action is that of hydration. It stimulates 
the secretion of the gastric juice. Dr. Herschell f ascertained that it 
acted alike in acid, alkaline or neutral fluids, and that it would dis- 
solve iooo times its weight of fresh blood-serum. Antiseptics, as car- 
bolic or salicylic acids, do not hinder its action. It is said to have no 
effect on starch (Martin J) ; this is denied by Woodbury ,§ who affirms 
that it converts starch into maltose. It dissolves intestinal worms and 
the diphtheritic membrane. 

Medicinal Uses. — It is employed as an aid to digestion in the 
various forms of dyspepsia, to dissolve the diphtheritic membrane , and 
as a tceniacide. Prof. Jacobi || applies it to the diphtheritic membrane 
in glycerin, I part to 4 ; Schaffer uses it in water, strength 5 per cent. 
— both frequently applied with a brush. 

Administration. — The dose is about gr.j-v, to be taken after 
meals in powder, aqueous solution, capsule, or compressed tablet. 
When prescribed in solution it must be freshly made. It is not official. 
It may be dispensed with HO, or alkalies. 

MINERAL TONICS. 
MANGANI PR^PARATA-PREPARATIONS OF MANGANESE. 

Manganese (Mn) is a normal constituent of the body, existing in 
small amounts in the blood, hair, bile, etc. 

Physiological Effects. — When given internally in small doses 
the appetite improves, the digestive functions are promoted and the 
body gains in weight ; these effects are supposed to be most conspicu- 
ous in conditions due to an insufficiency of iron, and probably of 
manganese, in the blood. If a large dose be taken the cardiac action 
is depressed and the blood pressure lowered. After a toxic dose, 

* The Pkarm. % and Trans. M'ch. 10, 1894. 
f Brit. Med. Journ., April, 1886, p. 640. 
% Jour, of Physiol., 1885, p. 336. 
\N. Y. Med. Jour., 1892, p. 115. 
|| Therap. Gaz., 1886, p. 145. 



TONICS. 169 

violent gastroenteritis ensues. Injected into the blood, or given 
hypodermically, the salts of manganese paralyze voluntary motion and 
reflex. action and arrest the heart in diastole. 

Medicinal Uses. — They have been used as substitutes for, or 
combined with, the iron-salts, in anosmia, chlorosis, and cachectic states, 
but are inferior to the latter remedies. 

The following are the official preparations : — 

Mangani Dioxidum {Manganese Dioxide) is the " native, crude 
Manganese Dioxide, containing at least 66 per cent, of the pure oxide 
(Mn0 2 )." It is a heavy, grayish-black, amorphous or crystalline pow- 
der, odorless, tasteless and insoluble in water or alcohol. It has been 
used as a substitute for iron in the above-mentioned diseases, and as a 
substitute for bismuth in gastrodynia and pyrosis. Dose, gr.j-x in pill, 
capsule or powder. 

Mangani Sulphas [Manganese Sulphate} (MnS0 4 -|-4H 2 0) occurs in 
transparent and colorless or pale rose-colored crystals, slightly efflor- 
escent in dry air ; without odor, but having a faintly bitter astringent 
taste ; soluble in water but not in alcohol. Its effects are those as 
above stated, and it is much more active than the black oxide. It is 
believed, also, to act as a cholagogue. It has also been used as a sub- 
stitute for iron. Dose, gr.ij-v. 

Potassium Permanganate is considered among the antiseptics, (a. v.). 

ACIDA MINERALIA— MINERAL ACIDS. 

Incompatibles. — Nitric, nitro-hydrochloric and hydrochloric acids 
being powerful oxidizing agents form explosive compounds with 
readily oxidizable substances as the carbohydrates, alcohols, ethers, 
sulphur, phosphorus and the sulphides. The mineral acids are incom- 
patible with the salts of lime, lead, silver, the carbonates, and hydrates, 
and they liberate the weaker acids in combination, and decompose 
the glucosides. 

Aids. — The tonics, bitters and pepsin, the latter with HC1. 

Physiological Effects. — Locally, the mineral acids, after neutral- 
izing the alkali of the skin and uniting with the dermal albumen to 
form acid albumens, have three forms of action ; (ist) in extreme dilu- 
tion they precipitate albumen, are irritant, narrow the calibre of the 
blood-vessels, and are hence termed astringent, if the action be temporary 
they are rubefacient] (2d) in greater strength they inflame the epidermis 
causing vesication ; (3d) and lastly in the pure state they are by reason 
of their affinity for water, and coagulating and decomposing action, 



170 MATERIA MEDICA AND THERAPEUTICS. 

powerfully esckarotic. The diluted mineral acids are usually classed 
with tonics ; but, although internally they exert a very considerable 
corroborant influence on the system, their action is in many respects 
peculiar and distinctive. In the concentrated form they are corrosive. 
When properly diluted with water and swallowed in medicinal doses, 
they allay thirst, increase the appetite, stimulate digestion, increase the 
flow of bile by duodenal irritation, and all possess great diffusive power- 
After absorption into the blood, they combine either with its alkaline 
bases or albumen, and often produce a restorative effect in morbid con- 
ditions of the circulating fluid, and in their passage out by the secretions 
act as astringents. According to Gubler, the mineral acids exist in the 
blood closely combined with albumen, but by the action of the excre- 
tory organs this combination is broken up, the albumen remaining in 
the vessels, the acid passing out united with other bases. Acids given 
on an empty stomach check the secretion of the acid gastric juice ; given 
on a full stomach they render its contents more acid; hence, if there 
be an excess of acid secreted by the stomach, they should be exhibited 
before meals, in small doses and well diluted ; while if there be too 
little acid secreted, they may be given after meals to supply the defi- 
ciency. 

Toxicology. — In cases of poisoning from the mineral acids the 
proper antidotes are the alkalies or the alkaline earths to neutralize the 
acid and thus render it inert, and the free use of the fixed oils or albu- 
men to protect the surface of the alimentary tract. 

Medicinal Uses. — They are employed as tonics, usually in com- 
bination with the vegetable bitters, in dyspepsia, especially where it is 
dependent on a deficiency of the gastric fluid ; in typhoid and other 
essential fevers; in purpura and in scurvy ; as astringents and styptics, 
in hoemorrhage from the stomach and bowels, and in colliquative sweats 
and diarrhoea ; to allay febrile heat and cutaneous irritation ; in phos- 
phatic diathesis ; and locally, as escharotics. 

Acidum Sulphuricum (Sidphuric Acid) (H 2 S0 4 ). 

Preparation and Properties. — This acid, formerly called Oil of 
Vitriol, is obtained by burning sulphur, mixed with nitre, over a stra- 
tum of water contained in a chamber lined with sheet-lead. It is a 
dense, colorless, inodorous, corrosive liquid, of a strongly acid taste 
and an oily consistence, which unites with water in all proportions 
with the evolution of heat. Its sp. gr. should not be lower than 1.840. 
It should contain not less than 92.5 per cent, by weight of absolute 
sulphuric acid, and not more than 7.5 per cent, of water. The diluted 



TONICS. 171 

acid is readily detected by a soluble barium salt, which precipitates a 
white insoluble barium sulphate; veratrine introduced into the diluted 
acid, and evaporated to dryness, leaves a crimson deposit. 

Effects and Uses. — In the concentrated form it is not employed 
internally, but is sometimes used topically as a caustic, acting by coag- 
ulating albumen, and its affinity for water and the organic basis. 

Toxicology. — When swallowed, it acts as a violent corrosive 
poison, causing a burning pain in the mouth, throat and stomach, and 
usually staining the lips, mouth and fauces with black sloughs, followed 
by the vomiting of matter resembling coffee grounds and containing 
blood. Occasionally the action of the poison is spent upon the upper 
part of the larynx, and death takes place from asphyxia, without the 
entrance of the poison into the stomach. The chemical antidotes are 
magnesia, chalk, the alkalies or solution of soap, and mucilaginous 
drinks should be afterward freely administered. 

Acidum Sulphuricum Dilutum {Diluted Sulphuric Acid) contains 
one part of sulphuric and 8.25 parts of distilled water. It therefore 
contains 10 per cent, of the official (not the absolute) sulphuric acid. 
Diluted sulphuric acid lessens thirst, aids digestion, and diminishes 
the secretions of the bowels and skin. It is given as a tonic, refriger- 
ant and astringent, in the dose of from gtt.x-xxx, t. d., in water, and 
should be sucked through a tube to prevent injury to the teeth. This 
acid is a particularly valuable remedy in typhus and typhoid fevers, 
colliquative sweats y cholera and choleraic diarrhoea; and it is the best 
corrective for the phosphatic diathesis. It is used topically as a gargle 
and a wash to ulcers. 

It may be taken in the natural form, since the water of the Oak- 
Orchard Acid Spring of Genesee County, New York, yields gr.x, of 
free sulphuric acid to the pint, and is well adapted to prolonged use as 
in the phosphatic diathesis. 

Acidum Sulphuricum Aromaticum {Aromatic Sulphuric Acid), or 
Elixir of Vitriol, is made by adding 100 parts of sulphuric acid to 700 
parts of alcohol and allowing the mixture to cool, then add 50 parts 
of tincture of ginger and 1 part of oil of cinnamon, with sufficient 
alcohol to make the product weigh 1000 parts. It is a reddish-brown 
liquid, \vith an aromatic odor and a pleasant acid taste, and is an 
agreeable substitute for the diluted sulphuric acid, administered in the 
same doses. It is the preparation most in use. 

Acidum Nitricum [Nitric Acid) (HN0 3 ). 

Preparation and Properties. — This acid is obtained by the 



172 MATERIA MEDICA AND THERAPEUTICS. 

action of sulphuric acid upon potassium nitrate. When pure it is 
colorless; but as found in the shops it is usually of a straw-color, 
owing to the presence of nitric peroxide. It should have a sp. gr. 
1.420 and contain 68 per cent, by weight of anhydrous acid. It is a 
corrosive, sour liquid, evolving white fumes when exposed to the air. 
It may be recognized by giving off dense red fumes when added to 
copper-turnings, by the morphine test (see morphina), and by striking 
a blood-red color, changing to yellow in minute quantity, with solu- 
tion of sulphuric acid and brucine. 

Effects and Uses. — The dilute acid is readily absorbed by the 
blood, and probably exists there either in the form of nitrates or com- 
bined with albumen (Gubler). It stimulates the glandular apparatus of 
the intestinal canal, apparently due to a local action. It is probably 
eliminated as a nitrate by the kidneys. Locally, nitric acid is a powerful 
caustic, acting by abstracting water and combining with the alkaline 
bases of the tissues. It is employed, in the concentrated form, as an 
escharotic to destroy warts and stimulate indolent sinuses, and diluted, 
as an astringent wash or gargle. Atthill* applies the fuming nitric acid 
within the uterus successfully, in the treatment of Menorrhagia due to 
granulations of the mucous membrane, in haemorrhage after the removal 
of a polyp, and in endometritis, on cotton wrapped round copper-wire 
or a catheter, the cervix being protected by a vulcanite tube. He 
states that applied in this way it seldom causes pain. It is also 
applied to the pustules of acne, and as a cauterant to ncevi, phagadcena, 
cancrum oris and rodent ulcer. 

Toxicology. — Cases of poisoning from this acid are to be treated 
with magnesia, the alkalies, or soap, and mucilaginous drinks. In 
poisoning from the swallowing, of nitric acid, the fauces and mouth 
are covered with yellow eschars, due to the formation of picric acid. 
Its fumes are poisonous and quite recently killed a man. Internally, 
it is used in the form of — 

Acidum Nitricum Dilutum {Diluted Nitric Acid), which contains one 
part of nitric acid and five and eight-tenths parts of water, by weight ; 
or 10 per cent, of absolute acid. Dose for internal use tnjj-xx, t. d., 
reduced with water. 

Acidum HydrocHloricum (Hydrochloric Acid — Muriatic Acid). — 
Preparation and Properties. — This is an aqueous solution of hydro- 
chloric acid gas (HC1), of sp. gr. 1.160, and is obtained by the action 

*" Clinical Lectures on Diseases Peculiar to Women," 1883, pp. 104, 199, 378. 



TONICS. 173 

of sulphuric acid on a solution of sodium chloride. The official acid 
is composed of 31.9 per cent, of absolute hydrochloric acid, and 68.1 
per cent, of water. It is, when pure, a transparent, colorless liquid, 
but has often a yellow color, owing to the presence of chlorine, iron, 
or other contamination. It gives off dense white fumes when in con- 
tact with ammonia, and evolves chlorine gas when heated with man- 
ganese dioxide ; in the diluted state it produces, with solution of silver 
nitrate, a white precipitate, insoluble in boiling nitric acid, but soluble 
in ammonia. 

Effects and Uses. — Locally r , it is an active caustic, abstracting 
water and uniting with the alkaline bases of the tissues. Strong baths 
of hydrochloric and other mineral acids exert a powerful influence 
upon the skin. Hydrochloric acid is readily absorbed by the stomach, 
either as a chloride or joined with albumen. Diluted, in small quan- 
tities, it augments the digestive power of the gastric juice, and probably, 
exists normally in that fluid. It is chiefly eliminated by the urine. 

Toxicology. — It has a corrosive taste and a suffocating odor, 
and is an active poison, though less irritating than sulphuric and nitric 
acids. A poisonous dose produces blackness of the lips, redness of 
the tongue, difficulty in swallowing, and violent gastric pain. Mag- 
nesia, soap, or the alkalies are the chemical antidotes : afterward 
mucilaginous drinks should be given. 

It is employed topically as a caustic, and diluted, as an application 
in diphtheria, and ulcerated stomatitis, and, internally, in the form of — 

Acidum Hydrochloricum Dilutum [Diluted Hydrochloric Acid — 
Diluted Muriatic Acid), which contains 6 parts of the official acid and 
13 parts of water, by weight; or 10 per cent, of the absolute acid. 
This is employed in typhoid and typhus fevers ; also to counteract 
phosphatic deposits in the urine, and in dysentery. In gastric dyspepsia 
and chronic gastritis attended with deficiency of the gastric juice, 
since it exists probably normally* in this fluid, it is useful, especially 
when combined with pepsin ; the liquor pepsini, as it contains both 
remedies, is an eligible preparation in this condition and should be 
taken after meals. Topically, it is employed as a sedative in urticaria 
and erythema (f^ 3^-j to water f^j); but the skin should not be abraded 
to whatever surface applied. Dose, Titv-xx, which may be given in 
infusions. 

Acidum Nitro- Hydrochloricum [Nitro- Hydrochloric Acid — Nitro- 

* " Human Physiology," 1887, p. 139. H. C. Chapman. 



174 MATERIA MEDICA AND THERAPEUTICS. 

Muriatic Acid}. — This acid is made by mixing i t 8 <j parts of nitric acid 
with S^t parts of hydrochloric acid, the resulting reaction liberating 
chlorine, and forming chloronitrous acid and water, as follows : HN0 3 + 
3HC1=C1 2 +N0C1 (chloronitrous acid) 4-2H 2 0. It has a deep golden- 
yellow color, and emits the smell of chlorine, which is the chief active 
constituent. Internally, it is employed as a stomachic tonic, and is 
thought also to be particularly efficacious in oxaluria, and diseases of 
the liver, as jaundice due to catarrh of the bile ducts. Rutherford's 
experiments on dogs show that it is an hepatic stimulant. It should 
not be given with mercurials. Topically, it is used as a bath, either local 
or general, in oxaluria and chronic hepatitis, for which purpose one to 
four ounces of the acid may be added to a gallon of water. Dose, 
from gtt. ij-v, properly diluted, and carefully increased, and taken 
through a glass-tube. 

Acidum Nitro-Hydrochloricum Dilutum (Diluted Nitro-Hydrochloric 
Acid — Diluted Nitro- Muriatic Acid) is made by mixing nitric acid (4 
parts) with hydrochloric acid (18 parts), and, when effervescence 
ceases, adding distilled water (78 parts). It should be freshly pre- 
pared for use. Dose, Tltij-x, diluted and taken through a glass-tube. 

Acidum Phosphoricum (Phosphoric Acid). — 

Preparation and Properties. — This is made by boiling phos- 
phorus in nitric acid and water, and driving off the nitrous compounds 
by heat. It contains not less than 85 per cent, by weight of absolute 
orthophosphoric acid (H 3 POj and 15 per cent, of distilled water, and 
is " a colorless liquid, without odor, of a strongly acid taste and 
reaction," and has a sp. gr. of 1.7 10. 

Effects and Uses. — It is a powerful caustic, penetrating the 
tissues very deeply. In its effects it resembles the other acids. In 
small doses, well diluted, it stimulates digestion and increases the 
circulation ; when given for too long a time it disorders digestion by 
diminishing the secretion of the acid gastric juice. In large doses it 
depresses the circulation, acting as a corrosive poison. 

Toxicology. — Cases of poisoning by phosphoric acid are to be 
treated on general principles, viz. : neutralize the acid by the alkalies, 
alkaline earths or soap ; protect the denuded surface by eggs, milk 
or mucilaginous drinks ; and counteract the resulting depression by 
opium, nutrient and stimulating injections, etc. It is used internally 
in the form of — 

Acidum Phosphoricum Dilutum (Diluted Phosphoric Acid) which 
is prepared by adding 1 part of phosphoric acid to 75 parts of distilled 



TONICS. 175 

water. It is a colorless, syrupy liquid, without smell, but having a 
sour taste, and contains 10 per cent, by weight of orthophosphoric acid. 

Effects and Uses. — It has been given as a tonic and alterative 
in scrofula and in rickets, but in the latter disease phosphorus is 
justly preferred. It may be given in dyspepsia, especially in those 
forms attended with acid eructations and heartburn, due to the fermen- 
tation of food or excessive secretion of acid by the stomach. In these 
cases it should be taken before meals. It is often added to cough 
mixtures. As it contains no free phosphorus it should not be pre- 
scribed to produce the medicinal effects of that drug. Dose, Tftx-xxx, 
diluted, and dispensed with syrups or elixirs. 

Acidum Hypophosphorosum Dilutum {Diluted Hypophosphoroits 
Acid) is a " liquid composed of about io per cent, of hypophosphorous 
acid (HP 2 H0 2 )," in water. It is employed for pharmaceutical purposes. 

ACIDUM LACTICUM-LACTIC ACID. 

Preparation and Properties. — This acid (HC 3 H 5 3 ) is formed 
in the souring of milk by the fermentation of its sugar under the 
influence of casein, between 68° and 84 F., and is a " syrupy, color- 
less, or pale wine-yellow liquid, having a slight bland or no odor, a 
very sour taste, and a sp. gr. 1.2 12." It is also made by the action of 
a peculiar ferment on a solution of sugar. The official acid contains 
75 per cent, of absolute lactic acid. Lactic acid unites in all propor- 
tions with water, alcohol and ether, but is insoluble in chloroform and 
carbon bisulphide. 

Physiological Effects. — In its effects it resembles the mineral 
acids, aiding digestion in small doses, while in large doses it disorders 
the stomach, causing flatulence and epigastric pain. It is a normal 
ingredient of the gastric juice, and it seems probable that the acidity 
of this secretion depends partly upon its presence. At all events, as 
far as digestion is concerned, it answers equally well with HC1. Given 
in large doses and long continued, it gives rise to rheumatic pains. 

Medicinal Uses. — -It is prescribed in certain forms of dyspepsia 
depending on a deficiency of acid in the gastric juice, as atonic dys- 
pepsia, apepsia, and irritative dyspepsia, when it is given after meals and 
frequently combined with pepsin ; in acidity and heartburn it may 
be taken before meals to decrease the secretion of acid. Topically, it 
is employed as a sedative in various cutaneous affections (fS^-j to 
water fgj), as urticaria and erythema, but the skin should not be 
broken. By Knocke,* the pure acid is rubbed well on corns (tylosis) 

* Journal Cut. and Venereal Dis., V, 1887, p. 122. 



176 MATERIA MEDICA AND THERAPEUTICS. 

which thus become softened and peel off under a few days' treatment. 
J. Sedziak applies lactic acid successfully to the lesions of laryngeal 
phthisis. Weak solutions are begun with (12 to 100 per cent.), and 
laid on the diseased tissues with a brush. The sound mucous mem- 
brane should be avoided, and the succeeding sense of burning relieved 
by cocaine spray. Lactic acid, pure or as a paste, is known to be of 
value in lupus, and may be applied on lint, the surrounding parts 
being protected with ointments. As a solvent for the false mem- 
branes of croup or diphtheria it has been employed as a gargle or by 
atomization. 

Administration. — Dose, TTLx-xxx, well diluted. Syrup of lacto- 
phosphate of lime (syrupus calcii lactophosphatis) is official, dose, f5ij-jv. 

Strontii Lactas {Strontium Lactate) Sr (C 3 H 5 3 ) 2 +3H 2 0. — This salt 
occurs as a white granular powder, odorless, with a slightly saline 
taste, and completely soluble in water. 

Effects and Uses. — It has some diuretic action and lessens the 
albumen of clironic Bright 's disease. Dose, gr.x-5ss, t. d., in solution. 

PHOSPHORUS. 

Preparation and Test. — Phosphorus (P), which is never found 
in a free state in nature, is obtained from the calcium phosphate ol 
bone-ash, by removing the lime with sulphuric acid, and afterward 
deoxidizing the residuum by heating with charcoal. It is a trans- 
lucent, highly inflammable, nearly colorless solid, resembling wax, 
having a peculiar garlicky smell; sp. gr. 1.830. It is insoluble in 
water, and dissolves sparingly even in the oils, ether, and alcohol, but 
is soluble in carbon bisulphide. It emits, when exposed to the air, 
w T hite fumes, which are luminous in the dark. It should be kept 
under water to prevent combustion. The most delicate test for free 
phosphorus is that of Mitscherlich, which consists in distilling the 
suspected substance with weak sulphuric acid in a flask and con- 
ducting the vapor in a tube through a glass condenser, the tube 
terminating in a bottle containing water placed under the condenser. 
That portion of the tube passing through the condenser must be sur- 
rounded by cold water contained within the latter, which, if phos- 
phorus be present in the distillate, will condense it, causing a peculiar 
luminosity to be visible when observed in the dark. The water in the 
bottle may also be tested for phosphorus. 

Physiological Effects. — Locally: when applied to the skin, 
phosphorus produces inflammation, ulceration, and even gangrene. 



TONICS. 177 

The fumes of phosphorus are irritating to the conjunctiva and respira- 
tory mucous membrane, and may produce necrosis of the maxillae, if 
the person exposed has caries of the teeth. This form is mostly 
observed among the artisans of match-factories. It has a distinctive 
odor and taste, both disagreeable, but should not be tasted except in 
great dilution. From the stomach phosphorus is absorbed by the 
blood, according to Bamberger. Either in the stomach or after entering 
the blood, a portion must unite with oxygen, or hydrogen, as the odor 
of a phosphuretted compound is generally perceptible in the exhaled 
air of a person taking it. Secretion : it increases the urinary secretion 
and the relative proportion of urea excreted, and gives to the urine an 
odor of violets. It stimulates the skin and increases the perspiration. 
In poisoning from phosphorus, albuminuria and hematuria have been 
observed. Nervous system : in small doses it is a tonic and stimulant 
to the nervous- system, aiding in the repair of waste. Circulation : it 
stimulates the circulation, increasing the frequency and fullness of the 
pulse and producing dilatation of the cutaneous capillaries. Large 
doses depress and weaken the cardiac action. Temperature : this is 
slightly elevated. Osseous system : it stimulates the formation of 
bone, especially the growth of the compact tissue, and the proportion 
of inorganic to organic matter is increased (Wegner*). Elimination : 
phosphorus passes out of the system by the liver and kidneys. 

Toxicology. — When taken in large doses, or for a considerable 
time, phosphorus acts as a gastro-intestinal irritant causing vomiting, 
purging, abdominal pain, an alliaceous taste in the mouth, the vomited 
matters and sometimes the stools being phosphorescent. The ejected 
matters usually give off the odor of garlic. Toward the end the pupils 
dilate, the abdominal walls are sensitive to pressure, there is great 
thirst and anxiety, and death may be preceded by convulsions. Hart- 
man^ asserts that the temperature is finally elevated, the faeces are of 
normal color, and the urine contains biliary pigment and acids. 
Jaundice is a frequent sequela ; according to Alter, j the pathological 
changes involved in its production are swelling of the mucous mem- 
brane of the biliary passages and hypersecretion of bile — both due to 
fatty infiltration of the biliary epithelium and followed by absorption 
of bile. Wolfs, § who has studied the post-mortem appearances in six- 

* Vir chow's Archives, 55, p. 11. 
f " Zur acuten Phosphorvergiftung," Dorpat, 1866. 
\ "Inaug. Diss.," Breslau, 1867. 
I " Inaug. Diss.," Berlin, 1868. 
12 



178 MATERIA MEDICA AND THERAPEUTICS. 

teen cases, states that the blood is rendered more fluid, coagulation 
prevented, and the corpuscles altered in form. Vetter,* however, 
found the latter in normal condition. Haemorrhages take place or 
form in the serous cavities, especially in the pericardium and pleurae, 
due, doubtless, to the changes in the blood and fatty degeneration of 
the capillaries and arterioles. The liver often becomes atrophied, 
undergoes fatty degeneration of its cells, as do also the other tissues, 
notably the muscles. The heart is soft and pale, and the parenchyma 
and cortex of the kidneys are infiltrated with fat-cells. In fact, the 
ingestion of phosphorus, either in toxic amount or continuously, tends 
to the production of a general steatosis. Death has been caused by 
gr.jss-iij ; also from swallowing an infusion of matches (Woodman and 
Tidy).f The period when fatal varies from a few hours to seven 
days. 

Antidotes. — In cases of poisoning, an emetic should be admin- 
istered at once, preferably copper sulphate repeatedly given in small 
doses, partly for its emetic action and partly as a chemical antidote, 
• since Bamberger J has shown that it forms with this salt a phosphide, 
thus checking the intensity of its effects. The oil of turpentine, an 
antidote introduced by Andant, § who exemplified its virtues in the 
case of a woman poisoned by matches, has been frequently and 
with success employed against phosphorus (Laboullene,|| Lecorch6,Tf 
Rommelaere**). Personne,ft experimenting on dogs poisoned with 
phosphorus, observed that almost all recovered to which turpentine 
had been given. He thought it formed with phosphorus an insoluble 
mass or inert combination (turpento-phosphoric acid, a spermaceti-like 
substance). French acid oil of turpentine, according to Vetter, (Joe. cit.) 
must be administered, and it should be old, as the real antidote appears 
to be oxygen in the form of ozone contained in oxygenated oil of tur- 
pentine. Fats and oils are to be avoided, as they increase the solu- 
bility of phosphorus. The after-treatment consists in the exhibition 
of a brisk cathartic, such as magnesia. 



* Virchow 's Archives, 53, p. 168. 

f " Forensic Med.," etc., 1882, p. 95. 

% Wurzburger Medicinische Zeit., 1866, p. 47. 

\Bull. Gen. de Therap., 75, p. 269; 76, p. 273. 

|| Qaz. des Hop., xlvi, p. 361 ; Gaz. Heb., 1874, p. 524. 

\Arch. de Pkys., t. i, p. 571; t. ii., p. 488. 

** Bull. Gen. de Therap., 82, p. 1 45. 

ft Bull. Gen. de Therap., 76, p. 353. 



ASTRINGENTS. 179 

Medicinal Uses. — In suitable doses, phosphorus is a valuable 
stimulant and tonic to those tissues in which it is normally found, and 
it has been employed with advantage in cases of neurasthenia and de- 
generation of nerve-tissue, especially in neuralgia ; though Anstie * 
says its utility is neither extensive nor reliable in the last disease. It 
is administered with benefit in rickets, being, by Kassowitz, styled the 
"iron of rickety children." It is serviceable in angina pectoris (attack), 
in Hodgkirfs disease, and it has proved useful in some cases of perni- 
cious ancemia. It is one of the best aphrodisiac remedies we possess 
in functional impotence, and has been given in certain cutaneous affec- 
tions, as lupus and psoriasis. 

Administration. — The dose of phosphorus is gr. sV-tV, which 
maybe had in granules. The official preparations are: pilulce phos- 
phori [phosphorus pills), each pill contains gr. t™ ; oleum phosphor atum 
(plwsphorated oil), a solution of phosphorus (i part) in ether and 
almond-oil, a sufficient quantity, dose, gtt. v— xx ; elixir phosphori 
(elixir of phosphorus), consists of spirit of phosphorus 210 c.c. with oil 
of anise, glycerin and aromatic elixir, q. s.,to make 1000 c.c, dose f 5j - 
Spiritus phosphori [spirit of phosphorus), is composed of phosphorus 
It 2 o parts, in alcohol 1000, dose, Til v-xxx. 

Zinci Phosphidum [Zinc Phosphide), (Zn 3 P 2 ), prepared by subject- 
ing fragments of zinc and phosphorus together to ebullition in a retort, 
through which a current of dry carbonic acid gas has been previously 
passed, has been employed in cases where the administration of phos- 
phorus is indicated. It occurs as a gray, crystallized body, unaltered 
by moist air, and easily decomposed in the stomach, with the evolution 
of phosphuretted hydrogen. It has been found efficacious as a nerve- 
tonic in hypochondriasis; also in chronic eczema, psoriasis, and other 
cutaneous affections. Dose, about gr. -h-\, in pills. 

ORDER V.— ASTRINGENTS. 

These are medicines which produce contraction and corrugation 
of the tissues by a local action. They constrict the capillaries, the 
minute glands and ducts, and coagulate albumen. The mineral astrin- 
gents are cauterants when applied to the delicate tissues. Their con- 
stitutional effects are somewhat analogous to those of tonics ; and, like 
them, they increase the tone and vigor of the body, and exercise a 
control over various disorders of the nervous system. But they are 

* " Neuralgia," etc., 1871, p. 180. 



180 MATERIA MEDIC A AND THERAPEUTICS. 

chiefly employed to cure relaxation of the fibres and tissues, to subdue 
inflammation of superficial parts, and to arrest haemorrhage and ex- 
cessive discharges from mucous membranes or other secreting surfaces. 
In checking morbid discharges from the bowels, astringents diminish 
the secretions from the intestinal canal, and restrain their peristaltic 
movements, accomplishing this by a local action. They are divided 
into Vegetable and Mineral astringents. Most of the former owe 
their astringency to the presence of a principle termed tannic acid, 
and differ from tonics in the absence of bitterness. The mineral prepa- 
rations usually classed among the astringents are those of lead, copper, 
zinc, silver, bismuth and alum, and are distinguished from the mineral 
tonics by their more decided astringency and a sedative action on the 

vascular system. 

VEGETABLE ASTRINGENTS. 

ACIDUM TANNICUM— TANNIC ACID. 

Preparation, Properties and Tests. — This acid, which is the 
active principle of the vegetable astringents, is usually extracted from 
powdered nutgall by the action of washed ether. It is a light, feathery, 
non-crystalline powder, of a yellowish-white color, and astringent taste ; 
is very soluble in water, and soluble, though less so, in alcohol and ether. 
Tests. — It produces a white flocculent precipitate with solution of gelatin, 
a bluish-black precipitate with ferric salts (ink), and white precipitates 
with solutions of the vegetable alkaloids • and these substances are to 
be, therefore, considered incompatible with all the vegetable astringents. 
There is a variety of tannic acid (kino-tannic acid) obtained from kino, 
catechu, and some other substances, which strike a greenish-black 
precipitate with the salts of iron, and is not convertible into gallic 
acid. 

Chemistry. — Tannic acid (HC M H 9 9 ) is a glucoside, yielding, be- 
sides glucose, gallic acid. Its hydrogen atoms are theoretically 
replaceable by bases, but the salts are not well defined. The most 
recent investigators consider tannic to be the anhydride of digallic 
acid. 

Incompatibles. — With the salts of iron (ferric and ferrous), lead, 
silver, antimony, the glucosides, and the alkalies, a precipitate is formed • 
also with gelatin and the alkaloids. 

Physiological Effects. — Tannic acid applied locally to mucous 
membranes is a powerful astringent, blanching and rendering them paler, 
and arresting their secretion. It precipitates peptones from watery 
solutions, but this does not take place* in the presence of hydrochloric 



ASTRINGENTS. 181 

acid (Lewin). It possesses feeble antiseptic powers. Its taste is 
astringent. It checks the secretions of the mouth and stomach by 
'constringing the calibre of the vessels, and it restrains intestinal peris- 
talsis. When applied in weak strength to the blood-vessels dilatation 
ensues, while a strong solution will contract them. Injected into the 
veins in large amount it coagulates albumen, causing fatal thrombosis. 
Introduced in the same way, gradually, in moderate quantities, it exists 
as tannate of albumen, being held in solution by the alkaline carbo- 
nates (Lewin). According to Stockman's* investigations tannic acid 
in the stomach unites with alkalies, and in the intestine is converted 
into gallic acid ; but it cannot be obtained as the latter, or at best a 
mere trace, from the blood. Probably the alkaline tannates formed in 
the stomach and intestine are absorbed at once, and on the amount of 
this absorption depends the quantity in the urine ; for that passing on 
to the intestine remains there a long while, being scarcely absorbed at 
all, is converted finally into gallic acid, and goes off by the bowel. 
Tannin is excreted in the urine of the rabbit as alkali-tannate, while in 
man it may be given a long time before it can be detected there with 
ferric chloride. The remote effects of tannin as an astringent would 
seem to be valueless; for when its affinities are satisfied in the blood, 
either with an alkali or albumen, it does not affect the calibre of the 
vessels nor precipitate albumen. 

Medicinal Uses. — It is used internally in the treatment of 
hemorrhage, diarrhoea and dysentery, where it is believed to act by 
forming a protective coating along the intestinal walls, and it is fre- 
quently prescribed in the form of tincture of catechu or kino. It is 
doubtful if it possess the power to lessen the urinary albumen in 
Bright 's disease, It is also used as an enema in diarrhoea, dysentery, 
prolapsus ani and fissure of the anus, and, as a topical application in 
hemorrhages ; in non-inflammatory piles with belladonna ointment; dis- 
charges from mucous membranes, as gonorrhoea and conjunctivitis, 
(diminishing the secretion,) gr. ij-v-x to aq. f5j and mucilage of sassa- 
fras pith f5j ; as a nasal douche in chronic nasal catarrh (gr. ij-v, x 
to aq. f5j) ; to check the bleeding of epistaxis, retained in place with 
a cotton-wad; as an ointment in fissure of the nipple; and as an 
astringent gargle in pharyngitis, or it may be applied to the throat 5j 
in glycerin fgj, with a brush. Dissolved in water gr. i-v to fSj, Morrel 
MacKenzie considers it one of the best sprays for chronic larnygitis. 

* Brit. Med. Journ., Dec. 4th, 1886, p. 1077. 



182 MATERIA MEDTCA AND THERAPEUTICS. 

Administration. — Dose, gr. j-iv, in pill occasionally repeated. 
Troches of tannic acid (trochisci acidi tannici) are made by rubbing 
together tannic acid, powdered sugar and tragacanth, and forming a' 
mass with orange flower water ; each troche contains of tannic acid 
gr. j. Glyceriie of tannic acid (glyceritnm acidi tannici) contains tannic 
acid 2 parts to glycerin 8 parts. Ointment of tannic acid {ungnen- 
tum acidi tannici) is made by rubbing up 20 parts of tannic acid with 
80 parts of benzoinated lard. For Collodium Stypticnm (see index) 
which contains tannic acid. 

ACIDUM GALLICUM- GALLIC ACID. 

Preparation, Properties and Test. — This principle is found in 
many of the vegetable astringents, but less uniformly than tannic 
acid. It is prepared by exposing a mixture of nutgall and animal 
charcoal in water to the air, in a warm place, for a month, when the 
tannic acid is gradually converted into gallic acid by the absorption of 
a molecule of water. Test. — Gallic acid (HC 7 H 5 5 +H 2 0) is distin- 
guished from tannic acid by not coagulating albumen or gelatin, or 
throwing down the alkaloids ; and it unites with organic and inorganic 
bases to form gallates. It does not precipitate ferrous salts ; with the 
ferric, an inky deposit is formed. 

Chemistry. — It occurs in small silky, nearly colorless crystals, 
having a slightly acid taste, and is soluble in boiling water, and 
slightly so in cold water. 

Incompatibles. — The mineral and organic bases, and ferric salts. 

Effects and Uses. — Gallic acid has but feeble local astringent 
powers. Gallic acid has a slightly acidulous taste, and is probably 
converted into tannic acid in the blood. Given by the stomach, it is 
more efficacious than the latter acid. It is an astringent of doubtful 
value, though extensively employed in hemorrhagic disorders, as 
uterine hemorrhage , hematuria, bloody diarrhcea y etc. But according 
to Stockman (loc. cit.) it has no other action than that of a weak organic 
acid, and only diminishes the alkalinity of the blood. For internal 
use, gallic acid is preferable to tannic, since it does not coagulate 
albumen. Sodium gallate is without effect on the calibre of the 
vessels. Both tannic and gallic acids have been employed to diminish 
the quantity of albumen in chronic Bright 's disease, but the proof of 
their utility in this condition is by no means conclusive. 

Administration. — It may be given in doses of gr.ij-v, in pill, 
every two or three hours. The ointment (not official) contains 10 per 



ASTRINGENTS. 183 

cent, of gallic acid with benzoinated lard. This ointment combined 
with stramonium ointment as a topical application, a hot sitz-bath, and 
a calomel purge, often relieves an attack of external piles. 

GALLA-NUTGALL. 

Description, Habitat and Varieties. — Nutgall is an excrescence 
found upon Quercus lusitanica, the Gall Oak {Nat. Ord. Cupuliferae), a 
small tree or shrub of Asia Minor. The gall nuts are produced by 
the puncture of the buds by a fly {Cynips qnerciis folii or Diplolepis 
gallce tinctorial) to form a nidus for its eggs. This occasions an irrita- 
tion and flow of juice to the part, resulting in the formation of a 
tumor around the larvae, which, on attaining maturity, perforate the 
gall and escape. Galls are produced chiefly in Syria and Asia Minor, 
and are imported from the Levant. They are brought also from Cal- 
cutta, being collected to some extent in India. Galls are spherical, 
about the size of a hickory-nut, with small tubercles on their surface. 

Fig. i 6. 




QUERCUS INFECTORIA (NUTGALL). 

The best are bluish or black externally and grayish within, without 
odor, and of a very astringent, bitter taste. 

Chemical Constituents. — They yield their properties to both 
water and alcohol, but best to the former, and contain tannic acid, 50 
to 60 per cent., and gallic acid, 3 per cent. ; mucilage, sugar, etc. White 
galls are collected after they have been perforated by the insect, and 
are inferior in astringency, containing only 30 per cent, of tamiic acid. 

Incompatibl.es. — See tannic acid. 

Effects and Uses. — Galls are powerfully astringent, due to the 
large percentage of tannic acid ; they are not much used internally. 
In the form of infusion or decoction they are employed as enemata in 
chronic diarrhoea and dysentery, and also as gargles. 

Administration. — Dose of the powder, gr.x-xx. The tincture 



184 MATERIA MEDIC A AND THERAPEUTICS. 

[tinciura galUe) (20 per cent, in glycerin and diluted alcohol) may be 
given in the dose of foj-iij, but it is used chiefly as a chemical test. 
The ointment {unguentum gallce) (20 parts to benzoinated lard 80 parts) 
is a favorite application in hemorrhoids, and may be advantageously 
combined with opium (5ss to ointment 5j). 

CATECHU. 

Description, Habitat and Varieties. — Catechu, formerly called 
Terra japonica, is an extract of the wood of Acacia Catechu, a small, 
prickly tree of India (Nat. Ord. Leguminosae). Twelve or fifteen 
varieties of the drug are described by pharmacologists. 

Properties. — It is usually met with in the shops in masses of 
various shapes and sizes, of a rusty -brown color externally and varying 
internally from a reddish or yellowish-brown to a dark-brown color. 
The best is of a dark color, and is easily broken into small angular 
fragments, with a smooth, glossy surface, bearing some resemblance to 
kino. It is almost without smell, and has a bitter taste. 

Chemical Constituents. — It contains about 50 per cent, of 
catechu-tannic acid, which strikes a greenish-black precipitate with 
ferric salts, and about 30 per cent, of an acid principle, called catechin, 
to both of which it owes its peculiar properties ; also, in small amount, 
quercitrin and catechu-red. 

Incompatible^. — See tannic acid. 

Effects and Uses. — The taste of catechu is strongly astringent 
and sweetish. This is one of the most powerful and valuable of the 
vegetable astringents, possessing also mild tonic properties. It is 
much employed in combination with other remedies in chronic diar- 
rhoea y dysentery and haemorrhages, and is best administered half an 
hour before meals. A catechu troche is a good deal used in relaxed 
conditions of the mouth and throat, to relieve the hoarseness of public 
speakers ; also in aphthous ulcerations of the mouth. Topically, it is 
employed as a styptic, and in solution as an injection in gonorrhoea 
and gleet (tincture, f3ij in water, f§ jv-vj). 

Administration. — Dose of the powder, gr.x to 5ss in bolus or 
emulsion. Of the compound tincture {tinctura catechu composita) the 
dose is fSj-iij- ; useful with morphia (or mistura cretae, f5j and tincture 
catechu, f5ss-j) in acute diarrhoea. The troches (trochisci catechu) each 
contain of catechu, gr.j, with sugar, tragacanth, and orange-flower 
water. 



ASTRINGENTS. 185 

KINO. 

Description and Habitat. — The term Kino is applied to the pro- 
ducts of several trees. The official variety is East India kino, which 
is the inspissated juice of Pterocarpus Marsupium {Nat. Ord. Legu- 
minosse), a lofty tree of Malabar. 

Properties and Constituents. — East India kino* is met with 
in small, angular shining fragments, of a dark-brown, or redish-brown 
color, brittle, but without smell. It contains kino-tannic acid, kino-red, 
pyrocatechin (a trace), and kinoin. 

Incompatibles. — See tannic acid. 

Effects and Uses. — Its taste is astringent and sweetish, and it 
tinges the saliva red. Kino is a powerful astringent, and is given in 
chronic diarrhoea and dysentery, and injected in leucorrhoea and gonor- 
rhoea (tinct. kino, f5ij in water, fSjv-vj). Topically, it is employed as a 
styptic and as a stimulant to indolent ulcers. 

Administration. — Dose of the powder, gr. x-5ss ; of the tincture 
(tinctura kind), (kino 10 parts, glycerin 15 parts, alcohol and water to 
make 100 parts of tincture), f5j-ij may be given, and it is frequently 
added to chalk mixture in diarrhoea. 

krameria— rhatany. 

Description and Habitat. — Krameria is the root of Krameria 
triandra and of K. Ixina (Nat. Ord. Polygaleae), shrubs of Peru, Bolivia, 
and New Granada. 

Properties and Constituents. — It occurs in woody cylindrical 
pieces, of the thickness of a goose-quill to twice that size — many 
radicles being often united to a common head. They have a dark, 
reddish-brown bark, and a tough central ligneous portion, of a lighter 
red color. They are without smell, but have a very astringent, bitter 
taste, which is much stronger in the cortical than the ligneous portion ; 
and hence the smallest pieces should be preferred, as they contain the 
most bark. Rhatany yields a large proportion of kramero -tannic and 
rhatanic-red. It imparts its properties to both cold and boiling water, 
but more fully to alcohol. 

Incompatibles. — See tannic acid. 

Effects and Uses. — Rhatany has a bitter, astringent taste. It is 
used in the treatment of chronic diarrhoea, dysentery, and intestinal 
hemorrhage, internally and by enema. Trousseau strongly recom- 
mends its use in fissure of the anus. It is also employed topically in 

*For an analysis of Kino, see Am. Jour, of Phar., April, 1889. 



186 MATERIA MEDICA AND THERAPEUTICS. 

hemorrhoids (ointment) and leucorrhoea (injection). The powdered 
extract is an ingredient in many tooth-powders, and the tincture is 
used also as an astringent mouth-wash. 

Administration. — Dose of the powder, gr. xx-xxx ; watery ex- 
tract (extractum kramerice), dose, gr. x— xv ; fluid extract (extractum 
kramerice fluiduni), dose f5ss-j ; tincture (tinctura kramerice), (20 per 
cent.), dose f5i-ij ; and syrup (syrupus kramerice), dose fSj-jv. The 
troches (trocJusci kramerice), each contain gr. ij of krameria with sugar, 
tragacanth and orange-flower water. 

ELEMATOXYLON— LOGWOOD. 

Description and Habitat. — Logwood, or Campeachy wood, is 
the heart-wood of Hsematoxylon campechianum {Nat. Ord. Legu- 
minosae), a medium-sized tree of Campeachy, and other maritime parts 
of tropical America, and now naturalized in the West Indies. The 
portion used in medicine, and also as a dye, is the heart-wood, from 
which the bark and white sap-wood are removed previous to ex- 
portation. 

Properties and Constituents. — It is imported in billets of dif- 
ferent sizes, of a dark color externally and a deep red internally ; , 
in the shops it is kept in chips or raspings. It contains tannic acid y a 
coloring principle called hcematein, hcematoxylin (C 16 H 14 6 ), resin, etc. 

Incompatibles. — See tannic acid. 

Effects and Uses. — It has a sweetish astringent taste, color- 
ing the saliva pink when chewed, and a feeble, not unpleasant smell. 
It is a mild astringent, useful in chronic diarrhoea and dysentery, and 
particularly well adapted to the weakened condition of the bowels 
which follows cholera infantum. Mothers should be told that the 
stools of infants taking haematoxylon will stain their napkins red. It 
is also employed in the diarrhoea of phthisis. 

Administration. — It is given in decoction in the dose of f 5j to 
adults, and f5j to children ; or watery extract (extractum hoemaioxyli), 
in the dose of gr. x— xxx in solution. 

QUERCUS ALBA— WHITE OAK. 

Description and Habitat. — The barks of several species of 
American oaks possess astringent properties, and are probably to be 
found in the shops, but the only official variety is Quercus alba, White 
Oak, (Nat. Ord. Cupuliferae). The inner b*ark is the portion used, 
but the leaves and acorns are also astringent. White-oak bark is 
distinguished by its whitish color. 



ASTRINGENTS. 



187 



Properties and Constituents. — When prepared for use, it is 
deprived of its epidermis, and is of a light-brown color and fibrous tex- 
ture. Water and alcohol extract its virtues, which depend mainly on 
the presence of querci-tannic acid (C 2s H 24 12 ), tannin, oak-red ', etc. 

Effects and Uses. — Its taste is bitter and astringent. A decoc- 
tion of white-oak bark is a good remedy in chronic diarrhoea and it is 
employed in the form of ointment (6 per cent, of extract in ointment) 
in haemorrhoids and prolapsus, and fissure of the amis, as a gargle in 
relaxation of the uvula, and as an injection in leucorrhcea (the decoc- 
tion) without inflammation and where the discharge is profuse, in check- 
ing which the mineral astringents have failed. It, however, stains the 
linen. 

Administration. — Of decoction of white oak f ,1 ij may be taken 
frequently. 

fig. 17. 




GERANIUM MACULATUM: RHIZOME. 



188 MATERIA MEDICA AXD THERAPEUTICS. 

GERANIUM-CROWFOOT, OR CRANESBILL. 

Description and Habitat. — One of the most powerful of the 
indigenous astringents is Geranium maculatum, {Nat. Ord. Geraniacese), 
a perennial herbaceous plant, growing in moist woody situations, with 
an erect stem one to two feet high, pale-green mottled leaves, and large 
purple flowers, which appear in April and May. The part used is the 
rhizome, which should be collected in the autumn. 

Properties and Constituents. — This, when dried, occurs in 
wrinkled, rough pieces, from a quarter to a half inch in thickness, 
furnished with slender fibres, of a dark-brown color externally, and a 
pale flesh-color within. It contains tannic and gallic acids with 
mucilage. 

Effects and Uses. — It has an astringent but not bitter taste and 
no smell. This is an excellent simple astringent, agreeing very well 
with the stomach, and might be advantageously substituted for the 
more expensive foreign drugs. It may be employed internally to 
fulfill the indications of kino, rhatany, etc., in bowel complaints and 
hemorrhages, and topically as an enema, gargle, injection, etc. 

Administration. — Dose, in pow T der, gr. x to xx; of the decoc- 
tion, f^j-ij may be given. A decoction in milk is given to children. 
The fluid extract (extraction geranii fluidnm) may be taken in doses of 

f^ss-j. 

hamamelis-witchhazel. 

Description and Habitat. — Hamamelis Virginica, [Nat. Ord. 
Hamamelaceae), is a shrub, from six to ten feet high, growing in the 
damp woods of the United States and Canada. The leaves are the 
official part, and should be collected in the autumn. They are bitter 
and astringent. The bark may also be used. 

Chemical Constituents. — Hamamelis contains tannic acid (8.10 
per cent.), a bitter-principle not yet accurately determined, and an 
odorous volatile oil. 

Effects and Uses. — Hamamelis is an astringent, and, according 
to Phillips, possesses probably a haemostatic and shrinking power over 
veins, especially those of the skin and mucous membranes. It has 
been used with success in hemoptysis* , and hematuria. It is benefi- 
cial in hemorrhoids,']' checking the bleeding and reducing the size of 
the enlarged veins. For this purpose it may be given internally and 
used as an injection, beginning with z] to water fjij, and gradually 

* Bull. Gen de The rap., cvi, p. 193. Dujardin-Beaumetz. Sur Hamamelis Virginica. 
t Ibid. 



ASTRINGENTS. 189 

increasing the strength. The injection should be taken morning and 
evening, and retained, and it must be continued for some time. It is 
also recommended topically in inflammations and congestions, applied 
by friction, in liquid form. 

Administration. — The fluid extract (extractum hamamelidis fliri- 
dum) is the only official preparation, dose, fgss-j. By the distillation 
of hamamelis an anodyne soothing and odorous fluid is obtained 
known as Pond's Extract. 

RUMEX— YELLOW DOCK. 

Description and Habitat. — The root of Rumex Crispus, [Nat. 
Ord. Polygonaceae), and other species, naturalized in North America. 

Chemical Constituents. — Extractive-matter resembling tannin, 
and rumicin, which is identical with chrysophanic acid. 

Effects and Uses. — It is slightly tonic and astringent by virtue 
of its tannin. 

Administration. — Fluid extract of rumex {extractum rumicis flui- 
duni) dose, f^j. 

The following vegetable astringents deserve notice, though less 
frequently employed than the foregoing : — 

Rosa Gallica (Red Rose) ; Rosa Centifolia (Pale Rose) (Nat. Ord. 
Rosacea^). The petals of these two species of rose, collected before 
expanding, are official, but those of almost every other species of cul- 
tivated rose may be employed for the same purpose as Rosa centifolia, 
The red rose is mildly astringent; the pale, slightly laxative. The fluid 
extract (extractum rosce fluidum) is used as a flavoring ingredient in 
gargles and mouth-washes, and to disguise the taste of other medi- 
cines, as Glauber or Epsom salts. The confection (confectio roses) is 
used as a basis for pills. Mel rosce (honey of rose), made with fluid 
extract of rose and clarified honey, is used as an addition to gar- 
gles; the syrup (syrupus rosce) is added to disagreeable mixtures. 
Aqua rosce (rose-water), prepared from equal parts of the stronger 
rose-water and distilled water, is much employed in collyria, etc. 
Aqua rosce fortior (stronger rose-water) has been added to the U. S. 
P. of 1890^ ungue?itum aquce rosce (ointment of rose-water) is made 
by melting together oil of almond 60 parts, spermaceti 12^2 rose- 
parts, white wax 12^ parts, borax y 2 part, and then gradually adding 
water 19 parts — a very soothing application, much used under the 
name of cold cream : serviceable when applied to blistered surfaces, 
chaps and lichen, and with sodium salicylate to prevent the pitting of 
small-pox. ■ 



190 MATERIA MEDIC A AND THERAPEUTICS. 

Oleum Rosae (Oil of Rose), is " a volatile oil distilled from the fresh 
flowers of rosa damascina," (Nat. Ord. Rosaceae). — It is employed for 
perfuming purposes. 

Rhus Glabra (Sumach) (Nat. Ord. Anacardiae). — This is an indi- 
genous shrub growing to the height of from four to twelve feet, having 
a somewhat bent stem " divided into straggling branches, covered with 
smooth light gray or somewhat reddish bark, and imparipinnate 
leaves " with from twenty-one to thirty-one lance-oblong, pointed, and 
serrate leaflets. The fruit is in " clusters of small crimson berries 
which are subglobular ; about one-eighth of an inch in diameter, dru- 
paceous, densely haired, containing a roundish-oblong, smooth puta- 
men." 

Chemistry. — They contain acid calcium and potassium malates, 
tannin, coloring matter, etc. (Maisch). 

Effects and Uses. — They are excellent astringents, especially 
valuable as a gargle in aphtha and other forms of sore mouth, and 
in pharyngitis, for which purpose the fluid extract (extr actum rhois 
glabrcB fluidum) may be diluted with two or more parts of water. 

Rubus (Blackberry). — The bark of the root of Rubus villosus, 
Rubus trivialis and Rubus canadensis (Nat. Ord. Rosaceae), the former 
(the common American Blackberry), an erect, prickly shrub, and the 
two latter (Dewberries) creeping briers. 

Constituents. — According to Krauss' * analysis the root-bark 
contains an amorphous glucoside, villosin, and about 10 per cent, of 
tannin. 

Effects and Uses. — They are very efficient mild astringents, 
which have been used with excellent effect in bowel complaints, espe- 
cially those of children, particularly acute diarrhoea. The astringency 
resides principally in the cortical portion, and hence the smallest roots 
should be preferred. 

Administration. — The fluid extract (extractum rubi fluidum) may 
be given in doses of f3j-ij ; the syrup (syrupus rubi) is made by adding 
25 parts of the fluid extract to syrup 75 parts, dose, f §ss. 

Rubus Idaeus (Raspberry) (Nat. Ord. Rosaceae), the fruit of which 
is mildly astringent. The fluid extract (extractum rubi idczi) (dose, 
f5i-ij), and syrup (syrupus rubi idcei) (dose, f5ss-j), are official; the 
syrup is used to disguise the taste of disagreeable medicines. 

Castanea (Chestnut). — The leaves of the Castanea dentata (Nat. 

* Am. Journ. Pharmacy, Dec. 1889. 



ASTRINGENTS. 191 

Ord. Cupuliferse), a stately tree indigenous to both hemispheres, are 
official. They should be gathered in the autumn while still green. 
They contain tannin, etc., and are used occasionally in zvhoo ping-cough. 
Dose of the fluid extract (extraction castanecB fluiduni), f5ss-ij. 

A large number of vegetable substances, both indigenous and 
foreign, have been used as astringents in addition to those enumer- 
ated, the astringent principle being the most common medicinal 
property with which plants are endowed. The foregoing list com- 
prises the most important. 

MINERAL ASTRINGENTS. 
PLUMBI PR^EPARATA— PREPARATIONS OF LEAD. 

Metallic lead is considered inert. The tests for lead' are sulphur- 
etted hydrogen and a solution of potassium iodide ; the former strikes 
a black and the latter a yellow precipitate with soluble lead salts. The 
editor* has ascertained that sulphuretted hydrogen will detect one 
part of a soluble lead salt in one million parts of water. 

Incompatibles. — The mineral acids and their soluble salts, the 
alkalies and alkaline earths, vegetable astringents, opium, potassium 
iodide, and the sulphides are incompatible with the plumbic salts. 

Aids. — The lead-salts are aided in their depressive action on the 
circulation by prolonged cold, aconite, veratrum viride, and ergot ; in 
their astringent effects by the salts of zinc, copper, bismuth and silver, 
and in their depressing influence upon nutrition by .mercury, antimony, 
copper and the metals, which increase tissue-waste. 

Physiological Effects. — When applied locally in solutions not 
too concentrated, they coagulate albumen, contract the blood-vessels, 
and consequently blanch the tissues, but are not absorbed by the skin ; f 
and they are sedative. When more highly concentrated solutions are 
applied, they act as irritants, producing inflammation. Their taste is 
sweetish and astringent. When administered in therapeutical doses, 
they act as astringents in the alimentary canal, checking secretion 
and causing constipation. Rutherford states that lead acetate is the 
only drug which decreases the secretion of the bile without causing 
purgation, and he attributes this effect to a direct action on the liver. 
The lead preparations probably enter the blood from the stomach 
as albuminates, and pass directly to the liver, J by which they are 

* Am. J. M. S., October, 1878, C. Biddle, M.D., U. S. Navy, 
f Journal de V Anatomie et de la Physiol., 1873, P- 2 35- 
\ Ibid. 



192 MATERIA MEDICA AND THERAPEUTICS. 

chiefly eliminated, though a trace may be found in the urine. From 
the intestine they are only slowly absorbed and in small quantity. 
They decrease the activity of the secreting functions, and frequently 
arrest sanguineous discharges, both natural and artificial. After absorp- 
tion the tissues generally appropriate lead as an albuminate, retaining 
it obstinately. After absorption they irritate the cardiac inhibitory 
centre, at the same time acting on the terminal intro-cardiac branches 
of the vagus, thus diminishing the frequency of the cardiac beat 
(which under large doses becomes intermittent), lessening the dura- 
tion of the systolic bruit, and prolonging the diastolic bruit; in 
this way a diminution in the volume and frequency of the pulse is 
produced.* 

Toxicology and Antidotes. — In excessive doses, several of the 
saturnine compounds are irritant and corrosive poisons, giving rise to 
gastro-enteric inflammation, and sometimes to paralysis, coma, and col- 
lapse. The toxic dose of lead acetate is Sj-ij, but it is rarely fatal, 
owing to the vomiting it produces. The proper antidote is sulphuric 
acid or some alkaline or earthy sulphate, in solution in a large quantity 
of diluent. 

Lead Poisoning. — When the system becomes impregnated with 
lead, either from the too long-continued use of its preparations medici- 
nally, from drinking water drawn through lead-pipes, or in certain 
trades, as plumbers and painters, or from exposure to its influence in 
lead-factories, the use of cosmetics and hair-dyes containing lead, or 
the eating of buns colored with chrome yellow, etc., a peculiar kind of 
plumbic poisoning is produced which shows itself by a variety of symp- 
toms, more or less tremor being the commonest to all. The most 
usual form of lead-poisoning is colic, sometimes termed colica Pictonum, 
and painter s colic, which is characterized by sharp abdominal pains, with 
hardness and depression of the abdominal parietes, anaemia, obstinate 
constipation, nausea and vomiting, a metallic taste in the mouth, and a 
hard, slow pulse. Dr. Ernest Harneck, from experiments on the lower 
animals, concludes that colica Pictonum is due to intense excitation of 
the intestinal ganglia by the lead, producing arrest of peristalsis from 
spasm of the muscular coat. Next in frequency is lead-arthralgy, in 
which there are severe pains in the limbs, attended by cramps, hardness 
and tension of the painful parts. Lead-paralysis is another, though 
less common variety of the disease, and is characterized by a loss of 

* Gaz. Hebdom., August, 1S83, Curci. 



ASTRINGENTS. 193 

voluntary motion, owing to the want of contractility of the muscular 
fibres of the affected parts. It most frequently affects the upper ex- 
tremities, and the extensor rather than the flexor muscles (wrist-drop). 
Occasionally disease of the brain (lead encephalopathy) is observed as 
one of the consequences of lead-poisoning, characterized by headache, 
temporary blindness, hysterical symptoms, and loss of consciousness; 
optic retinitis or neuro-retinitis may be found. The absorption of lead 
into the system is recognized by a saturnine coloration of the gums, of 
the mucous membrane of the mouth, and of the teeth. In a series of 
experiments made by the editor,* the fact was established that the 
emanations from fresh lead paint do not contain lead. It seems proven, 
therefore, that in order to induce saturnine poisoning, actual contact is 
necessary with paint or lead in some form. Females are more suscep- 
tible (4 to 1, Oliver f) and children J less so, to lead poisoning than 
males. Workers in lead tend to miscarry. 

The Antidotal Treatment of Lead Poisoning consists in the 
internal administration of solutions of sulphuric acid and of soluble 
earthy sulphates, as Epsom salt. Potassium iodide is employed as an 
eliminative, and it is the best remedy, gr. v-x, t. d. For lead-colic a com- 
bination of cathartics and morphia has been employed ; atropine some- 
times relieves the colic; amyl nitrite relieves the convulsions of the 
encephalopathy. In the treatment of lead-palsy, strychnine and elec- 
tricity may be used ; but it is a very intractable form of the disease. 
The use of sulphuric acid lemonade is resorted to by workmen in lead- 
factories, as a preventive of lead-poisoning, and no worker in lead should 
take food with unwashed hands. 

Medicinal Uses. — The preparations of lead are employed as 
astringents, sedatives and desiccants. For internal use the acetate is 
almost exclusively prescribed. It is a valuable remedy in hemorrhages, 
obstinate diarrhoea and dysentery, by reason of its astringent influence, 
and it is also serviceable in fluxes from the mucous membranes, par- 
ticularly of the bowels. Topically, lead-washes are employed to 
relieve superficial inflammation, to arrest morbid discharges, and as 
desiccants. They are objectionable, however, as eye-washes, from 
their often forming precipitates of lead upon the cornea. 

Piumbi Acetas {Lead Acetate). — Preparation and Properties. 
This salt [Pb(C 2 H 3 2 ) 2 +3H 2 0], known also as saccharum satnrni or 

* Am. J. M. S., October, 1878, C. Biddle. Prize thesis, 
f "Lead Poisoning," 1891. 

j Three cases are reported by W. Sinkler ; Med. News, July 28, 1894. 
13 



194 MATERIA MEDICA AND THERAPEUTICS. 

sugar of lead, is made by immersing lead in distilled vinegar, or litharge 
in pyroligneous or crude acetic acid. It occurs in colorless, needle- 
shaped crystals, which effloresce on exposure to the air. They have 
an acetous odor and a sweetish, astringent taste, and are soluble in 
both water and alcohol. 

Effects and Uses. — The effects of this salt are those of the 
saturnine preparations which have been already described. Its me- 
dicinal influence is sedative and astringent. In hemorrhages it is 
employed ijiternally, usually in combination with opium, and in this 
form it is one of the best remedies against the hemorrhage of typhoid 
fever, absolute rest being at the same time essential. This combina- 
tion is also much resorted to in the treatment of diarrhoea, dysentery 
and cholera, cholera morbus, and may be prescribed with advantage to 
arrest the night-sweats of phthisis. In the cure of internal aneurism 
the acetate is prescribed alone, but with unsatisfactory results. In 
acute diarrhoea, if there be abdominal pain and frequent serous stools, 
the acetate should be combined with opium : R Plumbi acetatis, gr. 
xij ; opii pulveris, gr. yj. M.S. — Ft. pil. no. vj ; one after each stool. 
This is equally efficacious in dysentery, but the proportion of opium 
should be increased. In yellow-fever it is employed to check the 
hsemorrhagic condition of the gastric mucous membrane. It is a 
dangerous remedy in chronic diseases, from the liability to lead- 
poisoning, when its administration is long continued. As a topical 
remedy, lead acetate, in aqueous solution, is extensively employed to 
relieve inflammation and diminish morbid discharges ; also in sup- 
pository with opium to check rectal hemorrhage. 

Administration. — Dose, gr. j-ij-viij, two or three times a day in 
pill with confection of rose. When applied to mucous membranes, as 
in gonorrhoea, the strength of the solution may be gr. ss-j or ij to water 
foj ; a good formula is : R Plumbi acetatis, zinci sulphatis, aa gr. viij ; 
aq. rosae, f§viij. M. S. Injection t. d. ; for phlegmonous inflammation, 
as boils, abscess, and prickly heat, 3ij to water Oj. When it is desirable 
to combine opium with lead as an external application, the following 
formula will be found a cheap and efficacious substitute for " lead- 
water and laudanum." 1^ Opii pulveris, 3j ; plumbi acetatis, oj- M. S. — 
Put the powder in a pint of boiling water and stir ; when cool apply 
externally on a cloth of several thicknesses ; a serviceable anodyne 
lotion for sprains, synovitis, paronychia, phlegmons and orchitis. 

Liquor Plumbi Subacetatis (Solution of Lead Subacetate). — This 
preparation, frequently termed Goulard's Extract, is an aqueous so- 



ASTRINGENTS. 195 

lution containing about 25 per cent of lead subacetate [Pb 2 0(C2H 3 02)2,] 
and is made by boiling lead acetate and litharge in distilled water. It 
is a colorless liquid which is decomposed on exposure to the air, with 
the formation of insoluble lead carbonate, and occasions a dense white 
precipitate with solution of gum. In other respects it resembles a 
solution of lead acetate. 

External Medicinal Uses. — It is employed, diluted, to promote 
the resolution of external inflammation and to arrest the discharges 
from suppurating, ulcerated and mucous surfaces. It is advantage- 
ously applied in the moist varieties of acute eczema, and also in cases 
accompanied with much heat ; and as a cooling lotion to ecthyma. 
In orchitis, solution of the subacetate applied frequently to the scrotum, 
on lint, together with absolute rest and support of the parts with 
oakum, constitutes an efficient plan of treatment. The official dilution- 
is liquor plumbi subacetatis dilutus {diluted solution of lead subacetate) 
commonly known as lead-water, and consists of solution 3 parts to 
distilled water 97 parts. Ceratum plumbi subacetatis, or Goulard's 
Cerate, is made by mixing Goulard's extract (20 parts) and camphor- 
cerate (80 parts) ; it is an admirable dressing to excoriated and blistered 
surfaces, burns and scalds. 

Plumbi Iodidum (Lead Iodide) (Pbl 2 ) is made by the double re- 
action of solutions of lead nitrate and potassium iodide. It is a bright 
yellow, heavy, inodorous powder, volatilizable by heat, sparingly 
soluble in cold water, but more soluble in boiling water. It may be 
given internally in the dose of gr. iij-jv, or more, in pill ; but it is 
principally employed topically in the form of ointment (unguentum 
plumbi iodidi) (10 parts to benzoinated lard 90 parts). 

Plumbi Nitras [Lead Nitrate) (Pb(N0 3 ) 2 , made by dissolving lith- 
arge in diluted nitric acid, occurs in white, nearly opaque, octahe- 
dral crystals, permanent in the air, of a sweet, astringent taste, and 
soluble in water and alcohol. Locally, lead nitrate is stimulant and 
feebly caustic. When in the presence of the H 2 S of decomposition- 
products, it breaks up the gas with the formation of lead sulphide, 
hence it is said to be disinfectant. Its antiseptic power is rated by 
Miquel at 1 to 277. It may be given internally, as a sedative astringent, 
in doses of gr.^-j, twice or thrice daily, in pill or solution. Dr. For- 
dyce Barker recommends it as an application to fissured nipples (gr.x in 
glycerin foj), and the breast must be carefully washed before nursing. 
Ledoyerts Disinfecting Fluid is a solution of lead nitrate 5j in water 

fSj. 



196 MATERIA MEDIC A AND THERAPEUTICS. 

Piumbi Oxidum (Lead Oxide) (PbO), or Litharge. — Preparation 
and Properties. — This is prepared by blowing air through melted 
lead, and is obtained also in the process for extracting silver from 
argentiferous galenas. It occurs in minute yellowish or orange-colored 
scales, insoluble in water. 

Effects and Uses. — It is never employed internally. It is some- 
times sprinkled over ulcers, but its chief use is in the preparation 
emplastmm piumbi, or lead-plaster (called also diachylon plaster), a 
lead-soap which is made by boiling lead oxide with olive-oil in water, 
and is chemically a mixture of lead oleate and margarate. It serves 
as a basis for most of the other plasters. Unguentum diachylon* 
(diachylon ointment) consists of lead-plaster 50 parts melted with olive- 
oil 49 parts, and incorporated when partly cool with oil of lavender 
i part. This is an excellent soothing application in chroiiic eczema 
with scales and infiltration, after the parts have been cleansed with 
sapo viridis, and it should be laid on with muslin ; it may be equally 
well applied to pemphigus and sycosis. Emplastrum saponis (soap- 
plaster), made by rubbing up soap with lead-plaster and water is an 
excellent discutient ; useful in threatened bed-sores. 

Piumbi Carbonas (Lead Carbonate), or White Lead, is a white pow- 
der, without smell or taste, and insoluble in water, and, as it occurs in 
commerce, is a compound of lead carbonate and hydrate (PbC0 3 ) 2 Pb 
(OH) 2 . It is never administered internally, but it is employed as a 
dusting powder — though there is danger of its absorption. Unguentum 
piumbi carbonatis (ointment of lead carbonate) (10 parts to benzoinated 
lard 90 parts). 

cupri pr^iparata— preparations of copper. 

Metallic Copper is inert. Cupric sulphate is now the only official 
copper salt. The tests for the soluble salts of copper are : potassium 
ferrocyanide (which throws down a mahogany-colored precipitate), 
ammonia (which strikes an azure-blue color), sulphuretted hydrogen, 
or ammonium sulphide (which throw down a deep brownish-black 
precipitate), and metallic iron (on which metallic copper is deposited 
from a cupreous solution). 

* A better preparation, because more soothing and grateful to the inflamed skin, is 
that known as Hebrew's Ointment, which consists of the best olive-oil, f^ xv; finely -pow- 
dered litharge, ^ lij— 3 vi ; and water, Oj. The water and oil are to be boiled over a steam- 
bath, the litharge sifted in and stirred, and the boiling kept up till all the particles have dis- 
appeared. During this process, 3 or 4 ounces more of water should be added; then stir till 
cool. 



ASTRINGENTS. 197 

Incompatibles. — The sulphides, the alkalies and their carbonates, 
the mineral salts (except the sulphates), the iodides and vegetable 
astringents. 

Aids. — See lead. 

Physiological Effects. — The salts of copper act locally as caus- 
tics, irritants, and astringents by their coagulating action on albumen ; 
applied to the sound skin they produce but little effect. They con- 
stringe the tissues and lessen the blood-supply to a part. Cupric 
sulphate is antiseptic (q. v.). Their taste is styptic and metallic. In 
the blood they probably exist as albuminates. Some observers have 
noted a gain in flesh, in animals and man, after a course of copper 
Taken too long they give rise to symptoms similar to plumbic poison- 
ing, viz., constipation, paralysis, etc. When exhibited in small doses, 
they seem to exert a corroborant influence over the cerebro-spinal 
system, and are occasionally employed to fulfill the indications to 
which tonics are applicable, as in neuralgia. In larger doses they pro- 
duce gastric irritation and act as emetics. Lauder Brunton * has 
ascertained experimentally that copper sulphate injected into the 
blood likewise causes retching and vomiting, probably brought about, 
he thinks, by irritation of the stomach and intestines, which is re- 
flected to the vomiting centre of the medulla. Copper is eliminated 
by the liver, intestines and kidneys. 

Toxicology and Antidotes. — In excessive doses, they produce' 
gastro-intestinal inflammation, vomiting, and disorder of the nervous sys- 
tem ; death, in fatal cases, is usually preceded by convulsions, paralysis 
and delirium. In cases of poisoning from the cupreous compounds, the 
best antidote is albumen, as white of eggs, milk, wheaten flour. The 
potassium f err ocyanide is also very efficacious, forming with the cupre- 
ous compounds an insoluble copper ferrocyanide. 

Medicinal Uses. — The salts of copper are employed therapeu- 
tically, both as internal and external remedies ; internally as emetics, 
astringents, and tonics ; externally, as stimulants, astrmgents, styptics, 
and caustics. 

Cupri Sulphas [Copper Sulphate), [Cupric Sulphate) (CuS0 4 +5H 2 0). 
Preparation and Properties. — This salt, known as blue stone and 
blue vitriol, is obtained by roasting the native sulphide, or by combining 
cupric oxide (CuO) and sulphuric acid. It occurs in fine prismatic 
blue crystals, which, by exposure to the air, effloresce slightly and be- 

* St. Bartholomew' 's Hosp. Reports, XII, p. 145. 



198 MATERIA MEDICA AND THERAPEUTICS. 

come covered with a greenish-white powder. It has a styptic, metallic 
taste, is entirely soluble in water, but insoluble in alcohol. 

Effects and Uses. — Cupric sulphate is antiseptic and germicidal. 
As an astringent, it may be given in doses of gr. y^ to j, or more, in 
pill, repeated so as not to occasion vomiting, and will be found ex- 
tremely valuable in the treatment of chronic diarrhoea, dysentery, and 
enteritis. It is also used as an antidote to phosphorus. As an emetic, 
the dose is gr. iij to v, or even more in narcosis. Topically, it is used 
as a mild escharotic to trachoma, condylomata, and ulcers, and in solu- 
tion to arrest haemorrhages and muco-purulent discharges, as gonor- 
rhoea, after the subsidence of the acute symptoms. In gonorrhoea, and 
gleet, gr. ^-j to water fSj is a suitable strength to begin with. In 
obstinate aphthce, after cleansing the patches, they should be touched 
with gr. ij to water fSj. As a disinfectant * a 2-5 per cent, solution is 
recommended "for the destruction of infectious material, not containing 
spores T 

The Oleate of Copper (not official) 1 to 6 parts in petrolatum molle 
is useful in the different forms of tinea. 

ZINCI PR^EPARATA— PREPARATIONS OF ZINC. 

Zinc in its metallic state is inert. The test for soluble zinc salts 
is ammonium sulphide, which throws down a white sulphide (the only 
white sulphide met with). 

Incompatibles. — The sulphides, the alkalies, fixed and volatile, 
silver nitrate, the vegetable astringents, and the acids. Between zinc 
sulphate and lead acetate a double decomposition takes place, lead 
sulphate being precipitated as an inert substance, and zinc acetate 
formed. 

Aids. — Remedies aiding copper and lead (q. v.). 

Physiological Effects. — Locally, they are haemostatic ; some of 
the zinc salts (nitrate, chloride) act as powerful caustics, by reason of 
their affinity for water and power of coagulating albumen. Zinc chloride 
is antiseptic and germicidal (q. v.). The zinc compounds are very 
analogous in their effects on the system to those of copper, but are 
less energetic. The soluble zinc salts (sulphate, chloride) are readily 
absorbed, and probably exist in the blood as albuminates, while the 
insoluble salts (oxide, carbonate) are slowly taken up by the blood. 
Zinc is eliminated from the system by the bile, intestines, and urine. 

* Committee on Disinfectants of the Am. Pub. Health Assoc. 



ASTRINGENTS. 199 

Toxicology. — In cases of poisoning (rare), albumen, demulcents, 
and opiates are to be administered. 

Medicinal Uses. — The zinc preparations are employed internally, 
as tonics ', astringents , and, in large doses, as emetics ; and topically, as 
caustics, astringents, and desiccants. 

Zinci Sulphas [Zinc Sulphate) (White Vitriol) (ZnS0 4 +7H 2 0). 
Preparation and Properties. — This is prepared by dissolving zinc 
in dilute sulphuric acid. It occurs in small colorless, transparent, pris- 
matic crystals, resembling those of magnesium sulphate. They have 
a metallic, astringent taste, are soluble in water and insoluble in alcohol, 
and produce their astringent effect by condensing the tissue and con- 
tracting the blood-vessels. 

Effects and Uses. — Internally, it is chiefly used in chorea and 
by Hammond in large doses (gr. ij-xx, t. d.). Dose, as a tonic and 
astringent, gr. j to v, in pill ; as an emetic (acting by gastric irritation) 
it is the promptest and safest that can be employed in cases of narcotic 
poisoning, in the dose of gr. x-xx, well diluted with water. It is given 
in spasmodic croup, q. v., to produce emesis. It is a suitable astringent 
for the treatment of obstinate chronic diarrhoea and in enteritis with 
profuse stools. Topically, it is much used as a caustic, and in aqueous 
solution as a collyrium in conjunctivitis (gr. ij-v, to water fgj, and 
mucilage of sassafras pith, f5j.); as an astringent nasal wash in chronic 
nasal catarrh, and in gonorrhoea, gleet and urethritis, in the strength of 
gr. j-ij-iij to water fSj ; in otorrhcea, gr. v to water f §j. It is the best 
local astringent to stop the discharge of persistent leucorrhoea, 5%-i] 
to warm water Oj. 

Zinci Oxidum (Zinc Oxide). — Preparation and Properties. — This 
is made by roasting zinc in the air, known as Commercial Zinc Oxide 
(Zinci Oxidum Venale), (not official) sometimes called tutty. A purer 
form is obtained by exposing precipitated zinc carbonate to heat, 
which expels the carbonic acid and water. It is a yellowish-white 
powder (ZnO), insoluble in water. 

Effects and Uses. — It is occasionally used in the treatment of 
epilepsy in the dose of gr. ij, in pill, gradually increased. It is now mostly 
employed topically as a dusting powder, and often combined with starch 
and applied in the early stage of acute eczema and to pemphigus, or in 
the form of ointment (ttnguentum zinci oxidi) (20 parts to benzoinated 
lard 80 parts). This ointment has a wide range of usefulness, it being 
serviceable in bed sores to keep the parts supple; in chilblain as a sooth- 
ing application after puncture of the blebs ; as a simple dressing to herpes 



200 MATERIA MEDICA AND THERAPEUTICS. 

and herpes zoster, roseola, sycosis, intertrigo, impetigo, chaps, and ery- 
thema. Zinc oxide ointment is a much used excipient. 

Oleate of Zinc (Oleatum Zinci) is made with zinc oxide 5 and oleic 
acid 95 parts. It is applied to excoriated surfaces and eczema, etc. 

Zinci Acetas (Zinc Acetate). — 

Preparation and Properties. — This is made by heating com- 
mercial zinc oxide in a solution of acetic acid and distilled water, and 
occurs in white micaceous crystals Zn^HgC^+HaO, very soluble 
in water, and efflorescent in dry air. 

Effects and Uses. — It is used chiefly as a topical astringent in 
ophthalmia, gonorrhoea, gleet, urethritis and leucorrhcea (5j to tepid 
water Oj) in the proportion of gr. ij to vj, or more, to water, fgj. As 
an injection in the third stage of gonorrhoea, it was the remedy pre- 
ferred by Bumstead,* and its strength should be regulated just short 
of irritation of the urethra. 

Zinci Carbonas Praecipitatus (Precipitated Zinc Carbonate) is obtained 
by the double reaction of solutions of zinc sulphate and sodium carbo- 
nate. It is a soft, white powder, of somewhat variable chemical com- 
position, similar in its action to the oxide, but is chiefly used as a 
dusting powder, and to make a mild astringent and desiccant cerate 
(5j to ointment 5v). 

Liquor Zinci Chloridi (Solution of Zinc Chloride) may be used to 
disinfect water-closets and sinks. It contains about 50 per cent, by 
weight of the salt. The evaporation of this solution yields — 

Zinci Chloridum (Zinc Chloride) (ZnCl 2 ), a whitish-gray, semi.- 
transparent, deliquescent mass, having the softness of wax, and soluble 
in water, alcohol and ether. 

Effects and Uses. — Its local action is that of a disinfectant after 
its affinity for water is satisfied. It then seems to unite with organic 
matter to form a new compound, which is either not decomposable 
itself, or prevents further decomposition by its presence. It is strongly 
antiseptic (1 to 526, Miquel) and germicidal. It is likewise a powerful 
caustic, and it is one of the best escharotics that can be exhibited, to 
produce healthy granulations in malignant or indolent ulcers, especially 
in lupus. It may be used as a lotion in the strength of gr. ij to f§j of 
water, or dissolved in a little alcohol, or in the form of paste, made 
with one part of the salt to two or four of flour. A solution of zinc 
chloride is employed as an antiseptic, and is also injected into the 

* l< Venereal Diseases," 1879, p. 59. Bumstead and Taylor. 



ASTRINGENTS. 201 

blood-vessels of anatomical subjects to preserve them for dissection. 
Burnett's Disinfecting Fluid is a solution of about gr.cc in water f§j. 

Zinci Iodidum (Zinc Iodide) (Znl 2 ) is made by digesting an excess 
of zinc with iodine diffused in water. It occurs in the form of a white 
deliquescent mass, or of fine needles, of a metallic, styptic taste, very 
soluble in water. Topically, it is a most valuable local stimulant and 
escharotic, equal if not superior in effect to the chloride. 

Zinci Valerianas (Zinc Valerianate) Zn(C 5 H 9 2 )2+H 2 is prepared 
by the double reaction of sodium valerianate and zinc sulphate. It 
occurs in white, pearly scales, having a faint odor of valerianic acid, 
and a metallic, styptic taste. It dissolves in loo parts of water and 40 
of alcohol. Used in epilepsy and nervous affections, in the dose of 
gr. i-ij, repeated several times a day, in pill or capsule. For zinc 
phosphide, see phosphorus. 

ARGENTI PR^PARATA— PREPARATIONS OF SILVER. 

In the metallic state, silver is wholly inert. The only preparation 
which is extensively employed is the nitrate. 

Incompatibles. — The salts of silver form white curdy precipitates 
with the chlorides and hydrochloric acid; with solutions of potash and 
soda they yield a brown argentic oxide; with the oxides and bromides 
yellow deposits are obtained, and with many of the organic acids they 
afford insoluble compounds. Silver nitrate is reduced by organic 
matter to an oxide, becoming blackened ; the extracts of opium and 
hyoscyamus are said not to produce this effect. 

Aids. — The copper, lead and zinc preparations enhance the effects 
of the silver-salts. 

Argenti Nitras (Silver Nitrate). — ; 

Preparation and Properties. — This salt (AgN0 3 ) is obtained by 
dissolving silver in diluted nitric acid. It is anhydrous, and occurs in 
transparent, colorless, shining, heavy, rhombic plates, which have a 
strongly metallic and bitter taste, and are wholly soluble in distilled 
water. 

Physiological Effects. — The local action of silver nitrate to 
mucous membranes is that of a caustic, by reason of its coagulative 
action on albumen. This action does not extend deeply, since a 
superficial protecting pellicle is formed. In solution it is extremely 
irritant to the mucous membranes as those of the nose, eye and 
urethra, etc., and soon excites a flow of muco-pus therefrom. It is 
haemostatic by constringing the calibre of the vessels. When moist- 



202 MATERIA MEDIC A AND THERAPEUTICS. 

ened and applied to the skin, a white superficial stain is formed, which 
soon becomes black on exposure to light, by reduction of the silver to 
the metallic state. Exfoliation of the epidermis follows its caustic action 
on the skin. Silver-nitrate is powerfully antiseptic and germicidal, 
ranking after corrosive sublimate in this respect (Miquel). Internally: 
it has a metallic, styptic taste. Small doses (oxide, gr. J^, nitrate, 
gr. y%) may be taken with considerable impunity by the stomach. But, 
in excessive quantity (of nitrate, gr. iij-v), it is apt to occasion gastro- 
enteric irritation, with disturbance of the nervous system ; and in these 
cases the antidote is common salt (sodium chloride), or any inert chlo- 
ride, which produces, when in contact with the nitrate, sodium nitrate 
and silver chloride. Silver nitrate has been thought always to undergo 
conversion into a chloride in the stomach; but more probably it unites 
with albuminous matters, which render it soluble. Nervous system: 
in animals, hypodermic injections of silver hyposulphite and albumi- 
nate have caused paraplegia ; in small doses, tetanic excitement, and 
in toxic, convulsions, were produced. On man the argentic salts have 
caused vertigo, loss of memory and nervous depression. The effects 
of silver on the nervous system are centric and not peripheral. In 
medicinal -doses it has a corroborant action on the nervous system ; 
and, after prolonged use, since its elimination takes place slowly y 
produces a peculiar indelible blueness or slate color of the true skin 
(argyria), due to a deposition of the metal in the tissues. This, it has 
been asserted, is preceded by a peculiar blue line on the gums, 
resembling that produced by lead-poisoning. Prolonged use of the 
silver-salts (in animals) causes a marked loss of weight. Circulation : 
the intravenous injection of the silver-salts impairs the coagulability 
of the blood, which is found to be dark and pitchy in color. Other 
symptoms noted by this method were probably due to the production 
of embolism and thrombosis. Elimination takes place by means of 
the bile, kidneys (chiefly) and intestines.* 

Medicinal Uses. — Internally, silver nitrate has been employed 
in the treatment of epilepsy, but it is much inferior to the bromides 
in the treatment of this intractable affection; and its effect in dis- 
coloring the skin is an objection to its protracted use. It is used 
successfully in locomotor ataxia, being especially extolled by Ro- 
senthall, Charcot, and others, in the dose of gr. J^, t. d. ; but in 
this disease the galvanic current, in addition to medicines, renders 

* yoiti-nal de P Anatomie et de Physiologie, 1873, p. 289. 



ASTRINGENTS. 203 

important aid. It has been prescribed, too, in that intractable con- 
dition called spinal sclerosis. In gastric ulcer and chronic gastritis it 
is also efficacious in small doses in pill-form, after the stomach is 
afforded rest by liquid diet, preferably with milk. As an astringent 
in chronic dysentery and diarrhoea, combined with opium its exhibition 
may prove serviceable. 

Topical and External Uses. — It is as an external agent that it is 
most resorted to. The topical application of silver nitrate is the most 
rational method of treating dysentery, either chronic or after the sub- 
sidence of the acute symptoms. Irrigation of the colon is so likely 
to be followed by tenesmus, that the latter stands in the way of local 
medication, though a preliminary cocaine-solution (4-6 per cent.) injec- 
tion or suppository, may obviate this difficulty. The dorsal position 
with the hips elevated is the one the patient should occupy, and from 
2 x / 2 to 5 pints of warm water with silver nitrate gr. xv-xxx to the 
pint, should be allowed to flow in through a long tube (Osier, H. C. 
Wood). It must not be forgotten that this procedure is often extremely 
painful and accompanied by tormina and tenesmus and rejection of 
the fluid. It is one of the best applications that can be made to 
inflamed mucous membranes, particularly mucous patches, either in the 
solid form or in solution (gr. x to water f$j). Topical applications of 
solution of silver nitrate gr. v-x-xx, to the fSj, are highly serviceable 
in acute and chronic pharyngitis, and tonsillitis, and to the post nasal space 
in acute and chronic nasal catarrh. When thus employed, if there be 
much phlegm about the part, it should be cleansed with Dobell's solution 
prior to the application of the medicament, and the latter applied upon 
a sponge-holder. ■ In chronic laryngitis, with free secretion, a drop or 
two of a weak solution gr. J^-j-ij, may be touched on the affected part. 
In conjunctivitis, either simple or granular, or in ophthalmia, gonorrhoea!, 
or non-specific, for the relief of which affections it is one of our chief 
therapeutical resources, collyria of the strength of gr. v-x to water 
f§j are to be used, and the effect on the conjunctiva should be coun- 
teracted by flushing it out with a solution of salt and water, or even 
cold water alone. As a collyrium it is contraindicated when ulcer of 
the cornea exists, as there is risk of forming an opacity. In chronic 
conjunctivitis its influence may be limited by applying the solution to 
the upper lid with a brush. In purulent forms, when the discharge is 
evidently purulent, instillations of solution of silver nitrate combined 
with cold compresses and antiseptic washes are indicated. Solution of 
silver nitrate in various states of dilution is successfully used to produce 



204 MATERIA MEDIC A AND THERAPEUTICS. 

healthy granulations in trachoma, fungous granulations, wounds and 
ulcers. As a preventive of bed-sores, when redness of the skin has set in, 
a solution of silver nitrate gr. x-xx to the fSj may be painted on, to 
constringe the superficial tissues and hinder the spead of the inflam- 
mation. In solution, this remedy is applied to porrigo, to the base of 
warts after abscision of the top to prevent further growth, and to 
stimulate to healthy action patches of chronic eczema. The strong 
injections of silver nitrate, formerly used to abort gonorrhoea, are now 
rarely resorted to, as they are extremely painful, augment the discharge, 
and seldom modify the course of the disease. In this disease, either 
of the male or female urethra, the best results are obtained from the 
remedy only when the acute symptoms have entirely subsided, and 
the strength should be gr. J^-j-ij, to water f§j, and care must be taken 
to avoid staining the linen with it. When employed for the cure of 
gleet, the solution should be applied directly to the seat of the disease 
within the urethra. Solution of silver nitrate, varying from gr. ij-x, 
or even more, according to the sensitiveness of the part, is injected 
into the membranous urethra to obtund hyperesthesia of the sexual 
organs in spermatorrhoea', lunar caustic, or the mitigated stick, may be 
introduced on a suitable holder to the sensitive urethral spot for the 
same purpose. More or less strangury and a muco-purulent discharge 
follows the application, but it does good. In otorrhoea a solution of gr. 
j-x,is introduced by instillation. When no stronger caustic is at hand 
it may be applied to destroy the virus of poisoned wounds, though its 
action is too superficial to be of much service. Silver nitrate stains 
can be removed by moistening the spot with tincture of iodine, and 
then washing it with solution of sodium hypophosphite. 

Administration. — The dose of silver nitrate internally is gr. \, 
gradually increased to gr. y 2 or j, t. d., in pill, made with Fuller's 
earth and petrolatum, and given soon after a little light food has been 
taken. For topical use, solutions are made of various strengths, from 
gr.ij-oss or more in f§j of distilled water, and the bottle should be 
protected by blue paper from the reducing action of light. An oint- 
ment is also employed. 

Argenti Nitras Fusus (Moulded Silver Nitrate — Lunar Caustic). 
For topical use, in the solid form, silver nitrate is melted and poured 
into small moulds. 

Argenti Nitras Dilutus (Diluted Silver Nitrate — Mitigated Lunar 
Caustic) consists of 50 per cent, each of silver nitrate and potassium 
nitrate. It is used externally, and can be had in pencils or cones. 



ASTRINGENTS. 205 

Argenti Oxidum (Silver Oxide) (Ag 2 0) is obtained by adding 
solution of potassa to a solution of silver nitrate. It is a tasteless, 
olive-brown powder, very slightly soluble in water. Its action and 
applications are analogous to those of the nitrate, and it is considered 
to be free from liability to discolor the skin. Dose, gr.ss-j, twice or 
thrice daily in pill. Used in pyrosis. 

Argenti Iodidum (Silver Iodide) (Agl) may be used in gastric 
affections instead of the nitrate. It is also said to have some alterant 
effects. Dose, gr. j-ij. 

Argenti Cyanidum (Silver Cyanide) (AgCN) is only used in the 
preparation of hydrocyanic acid. 

BISMUTHI PR.EPARATA— PREPARATIONS OF BISMUTH. 

Test. — Metallic bismuth is inert. The subcarbonate and sub- 
nitrate being of variable composition, no formulae are given. The 
test for a bismuth salt is to concentrate it in acid solution and then 
pour this into water, when a white precipitate falls, insoluble in tartaric 
acid. 

Incompatibles. — The bismuth-salts being insoluble can not be 
prescribed with other agents in solution. 

Aids. — Morphia and tannin enhance the astringency of the bis- 
muth-salts ; calomel and pepsin its sedative influence upon the gastro- 
intestinal tract. With these agents it may be prescribed either in capsule, 
powder, or lozenge. 

Bismuthi Subnitras (Bismuth Subnitrate). 

Preparation and Properties. — This salt is prepared by form- 
ing bismuth nitrate by dissolving bismuth in diluted nitric acid, suitable 
means at the same time being taken to get rid of arsenical contamina- 
tion, as metallic bismuth usually contains arsenic. Bismuth subnitrate, 
known as pearl white and magistery of bismuth, is a white, inodorous 
powder, insoluble in water. 

Effects and Uses. — Locally, it is protective, sedative, mildly 
astringent and antiseptic. The bismuth salts are almost tasteless. The 
salts are very insoluble, but to a slight extent are absorbed and slowly 
eliminated,* as bismuth has been found in the urine,f blood, etc., after 
their administration. The unabsorbed residue, passing down the 
alimentary canal, is converted into a sulphide and colors the stools 

* "Journal de V Anatomic et de la Physiologie, 1873, p. 243. 
f Transactions Am. Neurological Association, 1883, p. 24. 



206 MATERIA MEDIC A AND THERAPEUTICS. 

black. Internally, its medical properties are sedative and astringent. It 
is used chiefly to allay nausea and check vomiting in chronic affections 
of the stomach, as gastric ulcer, gastric cancer, acute gastritis, gastro- 
intestinal irritability and gastrodynia, in which gr. xv-xx should be 
given t. d., in order to obtain its effects. It is also much employed as 
an astringent in acute and chronic diarrhcea. As bismuth exerts its 
astringent influence on the intestinal tract by a local protective action, 
in the diarrlicea of adults it may be given, advantageously, in large 
doses (5ss-j), to be taken one hour before each meal. It is particu- 
larly useful in any form of diarrhoea where the stools contain mucus ; 
and acute diarrhoeas occurring during the summer season are also 
frequently benefited by it. The following combination is of great 
service : 1^ Morphinae sulphatis, gr. y 2 -) ; bismuthi subnitratis, 5j— ij ; 
sodii bicarbonatis, 5j ; sacchari lactis (seu pulveris cinnamomi), 5ij. 
M. et div. in chart, xii. Sig. — One powder after each alvine dejection. 
It is one of the numerous remedies for pyrosis. Topically, it is a good 
remedy in skin-diseases as acute eczema and ecthyma in the form of 
ointment. Jfy Bismuthi subnitratis, 5ij ; zinci oxidi, 5^ ; glycerini. 
f5jss ; acidi carbolici liquidi, TTlxx ; vaselini albi, ovi, M. S. Ft. ungt, 
Mixes into an enamel-like cream. The following forms a good anti- 
septic application in the treatment of ulcers and certain skin-affections, 
as impetigo, ecthyma, and rupia : 1^ Iodoformi, 5j ; acidi borici 5ij ; bis- 
muthi subnitratis, 5iv; petrolati, gij. M. Sig. — Ft. ungt. It is also well 
combined with camphor as a dusting powder and applied to intertrigo, 
or alone to chafed parts, or with boracic acid in the treatment of purulent 
otorrhoea of the external auditory meatus. An oleate of bismuth may 
be obtained. 

Administration. — Dose, gr. v-xx, or even 5ss, in powder or pill. 

Bismuthi Subcarbonas {Bismuth Subcarbonate) is recommended 
as a substitute for the subnitrate. It is thought to be more readily 
tolerated by the stomach, and is more soluble in the gastric juice, 
but it is less astringent. Dose, gr. v-xx, or even 5ss, in powder 
or pill. 

Bismuthi Citras [Bismuth Citrate) (BiC 6 H 5 7 ), a white, amorphous, 
odorless and tasteless powder, insoluble in water, is used with ammonia 
water in the preparation of — 

Bismuthi et Ammonii Citras [Bismuth and Ammonium Citrate), 
which occurs in glossy, translucent, colorless scales, of a slightly acid, 
metallic, but not disagreeable taste, very soluble in water, is a good 
preparation as an astringent. It is much more astringent than the 



ASTRINGENTS. 207 

insoluble preparations, but is more irritant. Dose, gr.ij, or in the form 
of an elixir, gr. ij to f5j ; or liquor, gr. j or ij to f5j. 

The valerianate (not official) has been used in neuralgia ; dose, 
gr.^-j, several times a day, in pill. 

CERII OXALAS-CERIUM OXALATE. 

Preparations and Properties. — This salt [Ce 2 (C 2 4 ) 3 -f 9H 2 0] is 
usually made by adding a solution of ammonium oxalate to any 
soluble salt of cerium, and is obtained also from the mineral cerite. 
It occurs as a snow-white, granular powder, inodorous and tasteless, 
insoluble in water, alcohol, and ether, but dissolved by sulphuric acid. 

Effects and Uses. — It resembles the salts of bismuth in its 
effects, particularly in exerting a sedative action on the stomach, and 
has been deservedly extolled in obstinate forms of vomiting, especially 
the vomiting of pregnancy. 

Administration. — Dose, gr. j, t. d., or oftener, in pill or powder. 
The cerum nitrate has been also employed, and is more soluble, dose, 
somewhat less. 

ALUMEN— ALUM. 

Alum [A1 2 K 2 (S0 4 ) 4 +24H 2 0] is a double salt, an aluminium and 
potassium sulphate. 

Preparation and Properties. — It is manufactured from alumi- 
nous schist, and sometimes by the direct combination of its constitu- 
ents. It crystallizes in regular octahedrons ; but is commonly found 
in the shops in large, colorless transparent crystalline masses, without 
any regular form. By exposure to the air it slowly effloresces ; it is 
soluble in cold water, and more so in boiling water ; and when heated 
it undergoes the watery fusion, swells up, and gives out its water of 
crystallization, and is converted into a white, spongy mass called 
dried alum. 

Besides the potassium alum, there are varieties in which the 
potassium is replaced by some other base, as ammonium or sodium ; 
the official alum was formerly the aluminium and ammonium sulphate, 
but this has been superseded by potassium alum. 

Incompatibles. — The alkalies and their carbonates, the salts of 
the acidulous radicals, lime-solution, magnesia and its carbonate, 
potassium tartrate and lead acetate are incompatible with alum. 

Aids.— It is aided in its action by the vegetable and mineral 
astringents. 

Physiological Effects. — It possesses antiseptic properties in the 



208 MATERIA MEDICA AND THERAPEUTICS. 

proportion of I to 222 (Miquel). The immediate topical effect of alum 
is that of a powerful astringent, in virtue of a constringent action on 
the capillaries and by the coagulation of albumen. It slightly hardens 
the unbroken skin. It is an exsiccant and a mild superficial caustic ; 
upon wounds it forms coagula. When it is applied to a part in large 
quantities, the astriction is soon followed by irritation. It has an 
astringent and sweetish, acid taste. Astringent doses are without much 
action upon the gastric sensibility. When taken internally, in exces- 
sive doses, it gives rise to vomiting, griping, purging, and even inflam- 
mation of the gastro-enteric mucous membrane, by the irritation it 
there sets up. After its absorption it acts as an astringent on the 
system generally, producing constriction of the tissues and fibres, con- 
traction of the capillaries, and a diminution of secretion. It is elimi- 
nated chiefly with the faeces. After large doses, Orfila detected it in 
the urine of dogs. 

Toxicology. — Death has resulted in man from dried alum Sjsl. 

Medicinal Uses. — Alum is employed internally in hemorrhages, 
chronic diarrhoea, and it is sometimes combined with cubeb in the 
treatment of gleet and gonorrhoea, as in the following prescription : 
1^ Pulveris aluminis, 5j ; pulveris cubebae, oiv ; pulveris cinnamomi, 
oSS. M. et Sig. — Tablespoonful in half a glass of water 3 times a day; 
an efficient mixture when it does not disorder the stomach. It has, 
too, been given as an emetic in croup. As a topical remedy in the 
solid form, it is valuable as an astringent-antiphlogistic in ophthalmia 
and tonsillitis, accompanied by hypersecretion ; upon the tonsils it 
can be lodged by insufflation. It is prescribed as a vaginal injection 
where the tissues become lax from wearing a pessary ; as a styptic in 
hemorrhages ; and to arrest excessive secretion from the mucous 
surfaces. In hemoptysis and chronic bronchitis, a strong solution of 
alum may be applied to the larynx by atomization. As an astringent 
it is employed in the form of solution in trachoma, conjunctivitis, 
gr. 5^-iij to water fgj ; and as an injection in gonorrhoea and gleet, 
attended with profuse discharge, gr. ij-vj to water f5ij ; in leucorrhcea, 
5j to tepid water Oj. In the treatment of pharyngeal cough and pha- 
ryngitis, the throat may be swabbed with an alum-solution, gr. xv-xx 
to water fgi. An alum-lotion is a good application to fissure of the 
nipples, forming bed-sores, and as a gargle in mercurialismus. 

Administration. — Dose, gr. x-xxx, in powder or solution, or made 
into pills with some tonic extract, and combined with an aromatic, as 
nutmeg, to prevent nausea. It may be agreeably given in the form of 



ASTRINGENTS. 209 

whey, prepared by boiling 5ij with milk Oj, and straining, of which the 
dose is fgij. Dried alum (alumen exsiccatuni) is employed internally in 
the dose of gr. v-x, and topically as a mild escharotic. 

Alumini Sulphas (Aluminium Sulphate) (Al 2 3S0 4 +i8H 2 0) is em- 
ployed topically as an astringent and antiseptic application to ulcers, and 
as an injection in gonorrhoea. The aqueous solution is used to preserve 
bodies for dissection. 

Alumini Hydras [Aluminium Hydrate) [Al 2 (OH) 6 ] is a white amorph- 
ous powder, insoluble in water and alcohol, but miscible in HC1 or 
KHO solution. It is mildly astringent and desiccant applied topically. 

ALUM- WATERS. 

Churchill Alum ( Virginia). — One U. S. gallon contains magnesium 
sulphate, gr. 86 ; calcium sulphate, gr. 88 ; ferric sulphate, gr. 51; alu- 
minium sulphate, gr. 72, and silica, gr. 10. 

Bath Alum-Springs ( Virginia). — Analyst A. A. Hayes : Contains 
in one U. S. gallon alumina, gr. 12; ferrous sulphate, gr. 22; with 
small quantities of the earthy and potassium sulphates. 

Rockbridge Alum-Springs {Rockbridge County, Virginia). — There 
are 3 springs, the one containing the most alumina yielding gr. 3 to 
the pint. They are astringent and styptic. 

Cresson Springs, of Pennsylvania, contain aluminium sulphate, 
gr. 21 ; and ferrous oxide, gr. 16 to the U. S. gallon. 

Medicinal Uses. — The alum-waters are applicable to the treat- 
ment of affections in which the aluminium preparations are prescribed, 
as chronic diarrhoea and dysentery. They are particularly useful where 
iron is indicated. 

ORDER VI.— STIMULANTS. 

Stimulants, of the class here included, are medicines which pro- 
duce a rapid and temporary exaltation of the cerebral functions, though 
their action is not confined to the brain. Their influence is most con- 
spicuous in conditions of morbid depression, when a marked tolerance 
of their action is established, and large amounts are borne. In health, 
when the powers of the system are at the normal standard, stimulants 
soon induce depression. Locally, they irritate and inflame the parts 
to which they are applied, and hence are classed with irritants. 

Stimulants are employed principally in disorders known as 

asthenic, and in all conditions of the system attended with exhaustion. 

From their action in arousing the energies of the nervous system, 

they exercise a control over many nervous disorders, particularly those 

14 



210 MATERIA MEDICA AND THERAPEUTICS. 

of a spasmodic nature. They are also frequently given with a view to 
their action on some one or other of the secretions. As stimulants to 
the gastro-intestinal canal, they are administered to promote digestion 
(when they are called stomachics) and to dispel flatulence (when they 
are known as carminatives). Topically, they are employed as rubefa- 
cients and vesicants. 

The more powerful and rapid stimulants are called diffusible. In 
overdoses, they act as violent narcotics and sedatives. The diffusible 
stimuli usually employed are vinous and spirituous liquors and the 
preparations of ammonia. Vegetable stimulants which contain a 
volatile oil are termed aromatics, and are usually given as stomachics, 
and carminatives. The volatile oils are also employed as local irritants. 

DIFFUSIBLE STIMULANTS. 
ALCOHOL. 

Preparation. — Alcohol is a product which results from a process 
termed the vinous fermentation, in substances containing grape-sugar. 
At a temperature of 80 ° F., the presence of a fermenting body con- 
verts a solution of grape-sugar into alcohol and carbonic acid. Starchy 
substances, being convertible into grape-sugar, also yield alcohol. 
Alcohol is obtained from vinous or fermented liquors by repeated dis- 
tillation. It is composed of about 91 per cent., by weight, of ethyl 
alcohol. 

Properties and Tests. — It is, chemically, ethyl hydrate (C 2 H 5 
HO). Official alcohol should be of the sp. gr. 0.820. It is a colorless, 
inflammable liquid, wholly vaporizable by heat, and unites in all pro- 
portions with water and ether. Contamination of fusel oil or amylic 
alcohol may be detected by agitation with concentrated sulphuric acid, 
when, if the alcohol become colored, the presence of the impurity is 
indicated in proportion to the depth of the color ; or solution of silver 
nitrate, with exposure to a bright light, will convert fusel oil into a 
black powder. 

Aids. — As a cerebral stimulant, ether, cocaine, cannabis IndiCa ; 
as a cardiac excitant nux vomica, ammonia and atropia. 

Contraindications. — Chronic hepatic, heart, vesical and renal 
disease, atheroma of the vessels, tendency to obesity, and alcoholic 
dypsomania. 

Physiologial Effects. — Locally, alcohol applied to the skin acts 
as an astringent by hardening the albumen and condensing the tissues. 
It evaporates rapidly, causing a feeling of coolness. When evapora- 



STIMULANTS. 211 

tion is prevented, it acts as an irritant (due to absorption and paralysis 
of the cutaneous vessels). It constricts, primarily, the capillaries of a 
mucous membrane, and, secondarily, dilates them. It is decidedly 
irritating to the delicate mucous membranes as the conjunctiva. It is 
an almost perfect aseptic fluid. Alcohol * is the intoxicating ingre- 
dient of all vinous and spirituous liquors.f When inhaled it may 
produce anaesthesia, stupor and death. Alcohol possesses a warm, 
acrid taste, and a pungent aromatic odor. It is rapidly absorbed from 
the stomach, so quickly indeed, that upon a person unaccustomed to 
its use it produces stimulating effects almost at once ; small doses in- 
crease the flow of the gastric juice by the production of hyperemia 
about the tubules, and thus excite the appetite and favor digestion. 
Large doses check the gastric secretion, precipitate the pepsin, and 
cause anorexia and nausea. When taken habitually, it produces a 
slow interstitial inflammation of the mucous membrane with hyper- 
plasia of the connective tissue-elements, which, contracting, compress 
the gastric glands. The secretion will then be much diminished, and 
the mucous membrane covered with a ropy, glairy mucus. Secretion : 
the secretions are at first increased, then diminished. Alcohol dimin- 
ishes the quantity of urea, uric acid, sodium chloride, phosphoric and 
sulphuric acids excreted in the urine, and augments the urinary flow 
Sugar is sometimes found in the urine after the ingestion of alcohol. 
Small doses stimulate the liver, while larger amounts alter the quality 
of the bile, which may be profuse or scanty. Nervous system : when 
taken internally, in small doses, it stimulates the cerebral hemispheres, 
possibly by the hyperaemia induced ; in large doses it causes excite- 
ment with impaired coordination of ideas, the judgment being soon 
impaired and the emotions excited, the individual becoming pugnacious, 
amorous, etc. ; in excessive doses it produces coma. Small doses 
stimulate the spinal cord, while larger amounts weaken the centers 
governing automatic motion and coordination, and lessen the sensi- 
bility of the cutaneous nerves, especially that of the fifth pair of cranial 
nerves. Large doses paralyze the vaso-motor nerves, giving rise to 
dilatation of the arterioles, flushing of the surface, and sensations of 
heat. In inflammatory diseases, medicinal doses contract the arterioles 

* Alcohol considered chemically, physiologically, medicinally and as a cause of dis- 
ease. Essay awarded the Henry C. Lea Prize, Jefferson Medical College, March 1878, by 
Henry Morris, M. D. 

f According to Dujardin-Beaumetz the toxic effects of the alcohols increase with the 
sum of their atomic weights, with the exception of the highest and lowest. 



212 MATERIA MEDIC A AND THERAPEUTICS. 

by giving tone to the vaso-motor system, and prevent the migration 
of white corpuscles (Farquharson). In toxic doses, the nervous cen- 
ters are involved in the following order: I. The gray matter of the 
convolutions and the higher functions of animal life (shown by dis- 
ordered intellection). 2. The basic ganglia (shown by disordered 
sensation and motion). 3. The cerebellum (shown by disordered 
equilibration. This maybe in part due to impairment of the muscular 
sense). 4. The spinal centers (shown by anaesthesia of the lower 
limbs, extending to the upper limbs and body, difficulty in performing 
automatic acts, impaired coordination, etc.). 5. The medulla oblongata 
(shown by labored breathing, and finally death from apncea). Circula- 
tion : alcohol at first stimulates, but afterward depresses the cardiac 
motor ganglia. In small doses it increases the frequency of the cardiac 
beat, without affecting the force or rhythm, increasing the rapidity of 
the contraction and shortening the diastole (Parkes and Wallowicz), 
and also elevating the arterial tension. This is soon followed by slow- 
ing of the heart and lowered arterial tension, and if the dose has been 
excessive, by weak and irregular contraction. Large doses depress 
and paralyze the cardiac muscle. Blood : alcohol must be in a certain 
state of dilution before it can be absorbed. It is said to precipitate 
the albumen in the blood, but it must be in a condition too diluted to 
accomplish this, nor are the consequences of an occasional indulgence 
sufficiently serious to warrant this statement. It diminishes the power 
of the red corpuscles to carry oxygen, and when taken continually 
alters the composition of the blood by its effect on the liver and diges- 
tion. Fat in the blood of drunkards is increased from 8.65 parts to 
1 1.7 parts per 1000 (Lecaun). Scharlau found 30 per cent, more carbon 
in the blood of drunkards than in that of healthy persons. This is 
due to the avidity with which alcohol combines with oxygen, prevent- 
ing the oxidation of the hydrocarbons. Respiration is at first quick- 
ened, but afterward slowed. The amount of carbonic acid exhaled from 
the lungs is diminished. In alcohol-narcosis the breathing is very 
slow, and death may result from apncea. Muscular system: the mus- 
cular power is weakened and the muscular sense diminished. Tem- 
perature : small doses slightly elevate the temperature. If large 
amounts have been taken, the temperature is depressed, owing to the 
radiation of heat from the dilated cutaneous vessels, to lessened oxida- 
tion of tissue, and, in alcohol-narcosis, or in the case of animals, to 
muscular inactivity. The power of resisting cold is lessened by the 
habitual ingestion of alcohol. A portion of the alcohol (about fSiij) 



STIMULANTS. 213 

disappears in the system, being probably oxidized as Anstie,* in a 
series of elaborate experiments on dogs, was able to recover only 
about one-fourth of the amount administered. The economy seems 
to be able to consume this quantity daily, storing it up as potential 
energy, anything above this being carried away under another form 
by the eliminating organs. Though f Siij may disappear in the system, 
it is not to be considered as contributing at all to the normal sup- 
port of the body. Experience gained in Arctic voyages proved that 
alcohol was totally unnecessary as an article of diet, and that tea 
as a restorative stimulant was an efficient substitute. Elimination: 
alcohol is eliminated unchanged in small proportion to the quantity 
ingested, by the kidneys, lungs, and to a slight extent by the skin, and 
probably by the liver, traces having been detected in the bile by Dr. 
Percy. 

In moderation, and when no idiosyncrasy against their use exists, 
beer, wine and spirits may be drunk during life without impairing the 
health. But the habitual use of alcoholic narcotics in excess gives 
rise to a number of well recognized mental and physical disorders; 
viz., gastric catarrh, visceral obstructions, cirrhosis of the liver, gout, 
organic disease of the heart, Bright's disease, delirium tremens, paralysis, 
and even confirmed insanity. The capillaries of the cheeks and nose 
may become dilated, enlarged and tortuous, giving rise to acne rosacea. 
The eyes, too, seem watery, and the conjunctivae hypersemic. 

Toxicology and Antidotes. — The symptoms of acute and of 
chronic poisoning by alcohol are too well known to need extended 
description. The acute form may be recognized by the narcosis, 
flushed face, full pulse, deep inspirations, dilated pupils, often sub- 
normal temperature, and alcoholic breath. The treatment in cases of 
poisoning from alcohol is the same as that which is to be pursued in 
cases of poisoning from opium, except the use of atropia and flagella- 
tion. Ammonia is a physiological antidote, and later the exhibition 
of strychnia does good. Mania-a-potu is found in acute poisoning 
from alcohol, and is due to the direct action of alcohol on a brain 
rather unaccustomed to its effects. It differs from delirium tremens, 
which is a delirium of a trembling type found in chronic alcoholism. 

Medicinal Uses. — Alcohol, in the form of vinous and spirituous 
liquors, is employed to rouse and support the system in asthenia, cere- 
bral ancemia, pycemia, septicemia, asphyxia, syncope, shock, small-pox, 

* The Practitioner, Vol. ill, p. 15. 



214 MATERIA MEDICA AND THERAPEUTICS. 

typhoid and typhus fevers, asthenic and malignant diseases, exhaustion, 
exhausting hemorrhages and suppurations, gangrene, to counteract the 
effects of the bites of venomous reptiles, in delirium tremens to u taper 
off with," and in poisoning from digitalis, tobacco, and other narcotics ; 
also as a stomachic in colic, flatulence, dyspepsia, nausea, etc. In typhoid 
and typhus fevers, alcohol probably acts as a physiological antidote to 
the blood-poison, and should be given in the very first stages of these 
fevers, regulating the size and frequency of the dose by the sounds of 
the heart and the character of the pulse. Rarely more than f5yj-viij 
are required daily. Its administration is particularly indicated if there 
be exhaustion, a weak, irregular pulse, feeble cardiac action, muttering 
delirium, and high fever. As a stimulant in diphtheria its administra- 
tion is of the greatest service in counteracting the depressing effects 
of the poison ; in cerebro-spinal meningitis to arouse from collapse ; to 
sustain the vital powers in capillary bronchitis ; and in the treatment of 
acute lobar pneumonia to prevent heart-insufficiency it is our most 
efficient remedy, the indications for its administration being the same 
as in typhoid fever. Indeed, the early administration of the prepara- 
tions containing alcohol furnishes our best means of counteracting the 
depressing action of disease in general. The true stimulant or sup- 
porting effects of alcohol probably depend upon its appropriation by 
the system through oxidation. In disease, large quantities are admin- 
istered which cannot be recovered in the excretions. But in health, 
when the powers of the economy are at the normal standard, it prob- 
ably circulates in the blood unchanged, and accumulates in the viscera 
or is eliminated by the secretions. In insomnia due to cerebral 
anaemia, a little alcohol at bed-time will often produce refreshing sleep. 
Alcohol, when prescribed to build up the system, should be given after 
food, in order to hinder it from diffusing too rapidly into the blood. 
For this purpose it is administered in conditions of anorexia, in con- 
valescence from acute maladies, in neurasthenia, phthisis and cerebral 
anosmia. Small doses induce aphrodisiac effects and are therefore 
serviceable in functional impotence. The hypodermic injection of a 
syringeful of brandy or whiskey, repeated if necessary, is an efficient 
restorative in collapse and asthenic conditions generally, especially 
where dissolution appears to be imminent. As a topical application, 
alcohol is used to produce cold by its evaporation ; as a styptic ; to 
harden the cuticle over delicate parts, as in bed-sores ; and as a stimu- 
lant with ammonia water it makes a useful wash in premature alopecia. 



STIMULANTS. 215 

Mixed with white of eggs, it forms a good coating, applied early with 
a fine brush, to bed-sores. 

Alcohol Absolutum {Absolute Alcohol), contains about I per cent, 
by weight of water. 

Alcohol Deodoratum (Deodorized Alcohol), is a liquid compound 
of about 92.5 per cent, by weight of ethyl alcohol in 7.5 of water. 

Alcohol Dilutum {Diluted Alcohol), or Proof- Spirit, consists of nearly 
equal volumes of alcohol and distilled water, and has a sp. gr. 0.928. 
It is used exclusively for pharmaceutical purposes. 

Preservation. — The U. S. P. directs that all the official alcohols 
be kept in well-stoppered vessels, in a cool place, and distant from fire 
and lights. 

Vinum {Wine). — The fermented juice of the grape consists of water 
and alcohol in varying proportions with, fixed and volatile acids, sugar, 
cenanthic acid and ether, tannic, malic and other acids \ potassium bitar- 
trate, etc. Wine loses most of its cream of tartar by age. It is em- 
ployed medicinally in typhus and typhoid fevers, convalescence, exhaust- 
ing chronic diseases, extensive suppurations, gangrene, asthenia, etc. In 
typh-fevers, it constitutes our chief therapeutic resource, and may be 
administered to the amount of one or two pints in the twenty-four 
hours, either pure or in the form of wine-whey. This is made by add- 
ing from a gill to half a pint of white wine to a pint of boiling milk, 
separating the curd from the whey, and flavoring with sugar and 
spices. 

The official wines are Vinum Album (White Wine), containing 
between 10 and 14 per cent, of absolute alcohol by weight; and Vinum 
Rubrum (Red Wine), containing between 10 and 14 per cent, of abso- 
lute alcohol by weight. Red wines are more astringent than white, as 
they contain more tannic acid. They are suited to conditions of 
ancemia. Port Wine contains tannic acid, and is used in chronic dysen- 
tery and diarrhoea, for its astringency. Madeira, which is the strongest 
of the white wines, is an excellent stimulant, but may be objectionable 
from its acidity. Champagne is a pleasant stimulant where gastric 
irritability is present, particularly iced champagne in yellow fever. 
Madeira and port contain about 23 per cent, of alcohol; sherry, 19 per 
cent. ; champagne, 13 per cent. As articles of diet, the stronger wines, 
when used in excess, often produce gout, and diseases of the kidneys 
and liver ; and except in advanced age and in feeble constitutions, or 
where the tuberculous diathesis exists, cannot but be considered as 
objectionable. 



216 MATERIA MEDICA AND THERAPEUTICS. 

Spiritus Vini Gallici [Brand))) is obtained by the distillation of the 
fermented unmodified juice of grapes, and should be at least four 
years old. It contains about 50 per cent, of alcohol, with zvater, vola- 
tile oil, tannic acid, coloring matter, etc. It is the best stimulus where 
a rapid and decided impression is called for, as in collapse and syncope ; 
and, from the tannic acid which it contains, is useful in bowel com- 
plaints, as chronic diarrhoea and dysentery. Spiritus Frumenti 
(Whiskey), obtained from fermented grain by distillation, is of about 
the same alcoholic strength as brandy, and may be substituted for 
it ; it does not contain tannic acid. Rum (Spiritus Sacchari), (not 
official), the ardent spirit obtained from sugar, is more sudorific than 
brandy. Gin is corn spirit flavored with oil of juniper, and owing to 
the oil of juniper which it holds in solution, it is an active diuretic as 
well as stimulant and stomachic. Spiritus Myrci^e (Spirit of Myrcia), 
bay rum, the spirit obtained by distilling rum with the leaves of myr- 
cia acris, is a refreshing topical application. 

The malt-liquors are useful where permanent stimuli are called 
for, as in diseases tending to emaciation, as chronic abscesses, asthe- 
nia, convalescence, and phthisis. In wakefulness caused by cerebral 
an&mia, a glass of ale or beer, at bed-time, is an efficient hypnotic. 
They are contraindicated in all chronic liver and renal affections and in 
disorders of the alimentary canal accompanied with acidity and flatu- 
lence, especially in those disorders depending on the fermentation of 
food. Although they contain a much smaller proportion of alcohol 
(2 to 6 or 8 per cent.) than the wines, yet their habitual ingestion will 
inevitably cause fatty degeneration of the liver and heart, already 
alluded to. Besides alcohol they contain extract of malt, and are, 
therefore, to some extent, nutritive. The best are porter and ale. 

Extractum Malti (Extract of Malt) (not official). — This is made by 
macerating and then digesting coarsely-powdered malt (the seed of 
Hordeum distichum, or barley (Nat. Ord. Graminaceae) caused to enter 
the incipient stage of germination by artificial means and dried) with 
water, straining and evaporating the fluid thus obtained to the consist- 
ence of a thick honey. It has a yellowish-brown color and the sweet 
taste of malt. It contains some dextrine, sugar, bitter and aromatic 
substances, and is used as a tonic in asthenia and neurasthenia. It pos- 
sesses few advantages over good malt-liquors. It is used as a vehicle 
for cod-liver oil. It aids the digestion of starch by promoting its con- 
version into dextrine and glucose. It may be given in doses of f5j-iv 
after meals. 



STIMULANTS. 2VJ 

AMMONliE PRiEPARATA— PREPARATIONS OF AMMONIA. 

Description, Source and Properties. — Ammonia (sometimes 
termed volatile alkali) is a gaseous compound of hydrogen and nitro- 
gen (NH 3 ), which is found abundantly as the result of the decay of 
organic substances, and is usually obtained by the action of lime on 
sal ammoniac (or ammonium chloride). It has a pungent odor, and 
is very soluble in water ; it is a powerful stimulant and local irritant, 
but is rarely used in medicine. 

Incompatibles. — With the carbonates, the acids, vegetable and 
mineral, solution of the acidulous salts, the earthy salts and lime- 
water. 

Aids. — Internally by alcohol, ether, and capsicum ; locally by 
cantharides and blistering agents. 

Physiological Effects. — Locally, ammonia in solution acts as an 
irritant, causing vesication, and after prolonged contact, sloughing of 
the surface. If the gas be sniffed into the upper air-passages irrita- 
tion, sneezing, and a flow of tears ensue ; and by reflex action over the 
nasal branches of the fifth nerve, (thus reflexly stimulating the excito- 
motor apparatus,) the blood-pressure is varied, the cardiac action in- 
creased, the vessels dilated and the volume of blood to the brain 
augmented : in this way the condition of syncope and shock is antago- 
nized by ammonia. When inhaled for any length of time it produces 
inflammation of the laryngeal and bronchial mucous membranes, and 
may cause pneumonia. It prevents fermentation of cane-sugar, and to 
some extent that of glucose. Kitasato found 0.3 per cent, solution fatal 
to the typhoid bacillus and cholera spirillum. Internally. — Their taste is 
generally pungent, ammoniacal and acrid. Within the stomach medici- 
nal amounts are stimulant (cardiac) and antacid. Lethal quantities are 
emetic (the carbonate), or powerfully corrosive (aq. amm. fort.). When 
introduced into the system via the stomach, the respiratory acts are 
quickened by a direct action on the respiratory centres. Nervous 
system : when injected into the veins of animals ammonia causes convul- 
sions, due to stimulation of the motor-centres of the spinal cord and its 
reflex functions. Circulation : after intravenous injections, a momen- 
tary fall in the arterial pressure takes place, followed by a decided and 
sudden rise (not due to any action on the vaso-motor nerves, as it 
occurs after section of the cord), and a corresponding increase in the 
rapidity of the pulse from stimulation of the accelerators of the heart. 
Blood : it prevents the coagulation of the blood, assists in retaining 
the fibrogenous materials in solution, and impairs the function of the 



218 MATERIA MEDICA AND THERAPEUTICS. 

red corpuscles as oxygen-carriers. Respiration : when injected into 
the veins the respiratory act is greatly accelerated. Elimination : it is 
probably, to a great extent, oxidized in the system, being eliminated 
as nitric acid, and perhaps as urea, by the kidneys. The effects just 
described are produced also by the following preparations of ammonia, 
which are employed as diffusible stimuli : — 

Aqua Ammoniae Fortior (Stronger Ammonia-Water). — This is an 
aqueous solution of ammonia of the specific gravity 0.900. It is a col- 
orless liquid, wholly volatilizable by heat, of a caustic, acrid taste and 
has a very pungent odor of ammonia. It is too strong for medicinal 
use internally in its unmixed state, as it contains 28 per cent., by 
weight, of gaseous ammonia. 

Toxicology. — It is a powerful corrosive poison, for which the 
diluted acids, as vinegar or lemon-juice, are the antidotes. In the 
form of gas it is antagonized by the vapor of vinegar. In the case 
of a man* who swallowed f5j of it, death followed suddenly, his 
breathing being obstructed, and the lips, tongue, uvula and tonsils much 
swollen, reddened and glazed. 

Effects and Uses. — It is used topically as a vesicant, and has the 
advantage over cantharides of a more speedy operation and non- 
affection of the urinary organs; but it is a very painful application. 

Aqua Ammoniae (Ammonia-Water) has a specific gravity of 0.959, 
containing 10 per cent., by weight, of ammonia, and is employed as a 
stimulant, antacid and rubefacient. As a stimulant, ammonia is admir- 
ably adapted for speedily arousing the action of the vascular and 
respiratory systems, as in cerebral anoemia, collapse, and shock, especially 
when it is an object at the same time to excite the action of the heart. 
For this purpose it is employed in low forms of disease, particularly in 
the typhoid state, in syncope, in asphyxia from narcotic poisons, and to 
counteract the effects of the bites of venomous reptiles. In syncope, col- 
lapse and asphyxia it is given as well by inhalation. In dyspepsia it is 
useful with a view to the relief of both acidity and flatulence. For 
internal use other preparations of ammonia are generally preferred, 
and this is used chiefly as a rubefacient. 

Administration. — Dose, internally, gtt x-xxx, largely diluted. 
As a rubefacient the official liniment (a. v.) may be used. 

Spiritus Ammoniae (Spirit of Ammonia) is a solution of ammonia 
in alcohol, containing 10 per cent, by weight of the gas. It is given 

* Guy's Hosp. Reports, xvn, 3d ser., p. 225. 



STIMULANTS. 219 

as a stimulant t antacid and carminative, in the dose of gtt. x-xxx diluted 
with water. But a pleasanter preparation, with similar properties, is — 
Spiritus Ammoniae Aromaticus {Aromatic Spirit of 'Amnionic?). — This 
is a solution of ammonium carbonate and water of ammonia, oil of 
lemon, oil of nutmeg, and oil of lavender flowers, in water and alcohol. 
It is a very agreeable antacid, stomachic and stimulant^ and may be 
given in the dose of gtt. xxx to f3j, or more, diluted with water. It 
is useful in alcoholismus as a substitute for liquor when the craving for 
this comes on. ' 

AMMONII CHLORIDUM-AMMONIUM CHLORIDE. 

Preparation and Properties. — This salt, formerly termed 
ammonia muriate, and often known as sal ammoniac, is obtained from 
the gas-liquor of coal-gas works (usually by neutralizing the ammonia 
with hydrochloric acid), and also in the preparation of animal char- 
coal from bones. It is brought in the crude state from Calcutta, for 
use in the arts, and in the refined state, for medicinal employment, 
from England. It occurs in white, translucent, tough, fibrous, hemis- 
pherical, convex concave cakes (NH 4 C1), about two inches thick, diffi- 
cult to powder, inodorous, of a pungent, saline taste, slightly deliques- 
cent, very soluble in water, and less so in alcohol. 

For medicinal use it is purified by the addition of water of ammo- 
nia to a solution of chloride, and occurs as a snow-white crystalline 
powder, soluble in 2^ parts of cold, and in its own weight of boiling 
water, and soluble also in alcohol. 

Incompatibles. — Solutions of caustic potash, soda or lime-water 
decompose the chloride NH 3 being given off; tartaric acid forms 
with it a tartrate. The mineral acids disengage HC1; with the soluble 
lead and silver salts chlorides are formed. 

Aids. — As an expectorant, ipecacuanha, squill, and senega. 

Physiological Effects. — The physiological effects of the ammo- 
nium salts have been considered under the head of Ammonia Prepara- 
tions. The local action of ammonium chloride is that of an irritant. 
In large doses it purges. Rutherford and Vignal found that it 
increased the activity of the intestinal secretory glands. In small 
doses, after absorption, it proves a powerful resolvent-alterative, dimin- 
ishing the solid constituents of the blood, with an increased flow of 
the secretions generally ; it has an especial action upon the mucous 
membranes, promoting nutritive changes and epithelial exfoliation. 
Under its use the solids of the urine are increased, except uric acid, 



220 MATERIA MEDICA AND THERAPEUTICS. 

which is slightly diminished. Even in very large amounts it is not 
considered poisonous. 

Medicinal Uses. — It is employed in the United States as a 
refrigerant in mild fevers attended with stoppage of the secretions ; as 
a resolvent in organic enlargements ; and in amenorrhcea. It is given 
in acute bronchitis and pneumonia as an expectorant, combined with 
fluid extract of glycyrrhiza (which somewhat disguises its unpleasant 
taste) and with other expectorants : 1^ Ammonii chloridi, 5ij ; extracti 
glycyrrhizae fluidi, f3j ; syrupus ipecacuanhas, f §iv ; syrupus pruni vir- 
ginianae, fgiij ; syrupus tolutani, q. s. ad fSyj. M. et Sig. — A dessert- 
spoonful every three or four hours in acute bronchitis when expectora- 
tion is beginning to be established. Dr. Peters * advocates its use in 
large doses combined with Huxham's tincture in rheumatic affections 
of the joints. In albumi7ioid or waxy infiltration of the liver it may 
benefit this essentially chronic affection, in doses of gr. x-xx, t. d. 

In the early stages of cirrhosis of the liver it is recommended; but 
there are no remedies that can be relied on to remove the new cicatri- 
cial connective tissue upon which this malady depends. 

Administration. — Dose, gr. v-xxx every two or three hours, in 
aqueous solution disguised with aromatic elixir, or syrup of orange. 
Topically it is used in solution (immediately upon being dissolved) as a 
refrigerant lotion (§j to water Oss), in cutaneous affections and indolent 
ulcers (Sj to water Oss). Troches of ammonium chloride (trochisci 
ammonii chloridi) each contain ammonium chloride gr. ij with sugar, 
extract of liquorice, tragacanth, and syrup of tolu. 

Ammonii Carbonas {Ammonium Carbonate) (NH 4 HC0 3 .NH 4 NH 2 
C0 2 ), being analogous in its effects to those of the preparations of 
ammonia, is considered here. 

Preparation and Properties. — It is prepared by subliming a 
mixture of ammonium chloride and chalk, and consists of a mixturef 
either of one or two molecules of acid ammonium carbonate and one 
molecule of ammonium carbonate. It occurs in whitish, transparent 
masses, wholly dissipated by heat, of a pungent, ammoniacal odor, an 
acrid, alkaline taste, and is soluble without residue in water. On 
exposure to air it becomes opaque, falls into powder, and deteriorates 
by the loss of ammonia. 

Effects and Uses. — Its indications are the same as those of solu- 



* N. Y. Med. Rec, Jan. 23d, 1886. 
f "U. S. Dispensatory, 1888, p. 172. 



STIMULANTS. 221 

tion of ammonia, to which it is preferred for internal exhibition as a 
diffusible stimulant. It is especially valuable in pneumonia, and by 
some therapeutists is relied on to the exclusion of other medica- 
tion in this disease. By others it is here regarded serviceable only 
as a stimulant ranking after alcohol, and without influence to prevent 
heart-clot (Loomis). The truth seems to be that it is adapted only to 
cases which can be antagonized by its physiological action. It is a 
useful adjunct to other remedies in the treatment of capillary bronchitis ; 
and in chronic bronchitis with profuse expectoration, diminished strength 
and impeded cardiac action, its exhibition, gr. v, every hour or so, is 
indicated. It has been recommended in threatened thrombosis, as that 
of the puerperal state. 

Administration. — Dose, gr. v-x, in pill or preferably in solution 
with acacia and syrup, as follows : 1^ Ammonii carbonatis, 5ij ; pul. 
acaciae, 5vi; syrup, aurantii florum, f§ij ; aquae destillatae, q.s. ad fSvi. 
M. S. — Each tablespoonful represents gr. x of the carbonate. The 
fluid extract of glycyrrhiza somewhat disguises its unpleasant taste. 
Mixed with some aromatic oil (as that of bergamot or lavender), it is 
used as a smelling salt in syncope. It should be kept in a well-stop- 
pered bottle. 

Ammonii Nitras {Ammonium Nitrate) (NH 4 N0 3 ), is a colorless 
crystalline salt, deliquescent, soluble in water, and is employed in 
making nitrous oxide gas. 

AROMATICS. 

Aromatics owe their virtues to the presence of oils obtained from 
them by distillation, and termed volatile oils (plea volatilia), some- 
times also distilled and essential oils. These oils possess, in a high 
degree, the odor and taste of the plants from which they are procured. 
Locally, they are powerful irritants, and, when taken into the stomach 
in over-doses, act as acrid poisons. Many of them are antiseptic and 
germicidal. They pass partially into vapor at ordinary temperatures, 
and are completely volatilized by heat; hence, decoctions and extracts 
are improper preparations of the aromatics. The distilled oils are 
inflammable, very slightly soluble in water, but soluble in alcohol and 
ether. Their ultimate constituents are, usually, carbon, hydrogen, and 
oxygen; and on exposure to the air they gradually absorb oxygen, 
become thicker, less odorous, and of a deeper color, and are finally con- 
verted into resins. The effects and uses of most of the members of this 
group are similar. In medicinal doses they are used as carminatives 
and antiflatidents, and are combined with purgatives to prevent griping. 



222 MATERIA MEDICA AND THERAPEUTICS. 

Most of them are also useful as flavoring ingredients. To many ot 
the volatile oils emmenagogue virtues have been ascribed; but these 
effects are only produced by poisonous doses. Topically, they are 
used as rubefacients, antiseptics and to allay neuralgic pains. 

CAPSICUM— CAYENNE PEPPER. 

Description and Habitat. — Capsicum or Cayenne pepper is the 
fruit of Capsicum fastigiatum [Nat. Ord. Solanaceae), an American 
tropical plant, naturalized in most warm climates, and cultivated in 
our gardens. C. fastigiatum is a small shrub, with a crooked, branch- 
ing stem, producing in each fork two or three fruits from one-half to 
three-quarters of an inch long, of a subconical form and crimson or 
yellow color. The pods, when dried and ground, form capsicum, the 
best of which is the African, or bird's-eye pepper, as they contain the 
most capsaicin. 

Properties and Constituents. — Powdered capsicum has a 
bright-red color, which fades upon exposure to light, an aromatic 
peculiar smell, and a burning taste. An acrid, crystalline principle 
termed capsaicin* (C 9 H u 2 ), slightly soluble in water, but very much 
so in alcohol and ether, exists in capsicum, associated with resin, 
fixed and volatile oil. 

Contraindications. — Capsicum should not be given in acute 
inflammatory affections of the stomach, intestines, or genito-urinary 
apparatus. 

Physiological Effects. — Locally, capsicum acts as an irritant, 
and vesication may be produced by prolonged contact with the skin. 
When applied to the mouth or nose it induces sneezing. Intei'nally : 
Its taste is acrid and burning. A medicinal dose causes a feeling of 
warmth in the stomach. Secretion : it stimulates the glands with 
which it comes in contact, and increases the flow of the saliva and the 
gastric and intestinal juices. In large doses it acts as a gastro- 
intestinal irritant. Circulation : it increases the action of the heart. 
Elimination : it passes out of the system by the kidneys, increasing 
the flow of urine, and sometimes producing vesical tenesmus and 
aphrodisiac effects. 

Medicinal Uses. — Capsicum is principally employed as a condi- 
ment and stomachic, and is very useful in torpid conditions of the 
digestive organs, or as an adjunct to other remedies to arouse the sus- 

* Fluckiger, " Pharmacographia," 2d ed., p. 454, isolated also a volatile alkaloid hav- 
ing the smell of conium, from the seeds and pericarp of capsicum. 



STIMULANTS. 223 

ceptibility of the stomach. Its constitutional effect is not in propor- 
tion to its local effect, and it is, therefore, of no great efficiency as a 
diffusible stimulant. It is a good stomachic in the dyspepsia of 
drunkards ; it also may be given as a substitute for liquor in alcohol- 
ismus. It is employed as a gargle, and also as a cataplasm, or on lint 
to cause counterirritation ; to the neck, in torticollis, for example. 

Administration. — Dose, of the powder, gr. v-x, in pill ; of the 
tincture (tinctura capsici), (5 parts to diluted alcohol 95 parts), 1ftx-f5j ; 
of the fluid extract (extractum capsici fluidum), TTLv-x. The oleoresin 
(oleoresina capsici) is a powerful rubefacient, and may be given internally 
in the dose of gr. ss-j, in pill or capsule. A plaster (emplastrum capsici) 
is also official. For a mild counterirritant effect an infusion of the 
pods may be applied on lint. 

PIPER— PEPPER. 

Description, Habitat and Varieties. — Black pepper is the 
unripe fruit of Piper nigrum {Nat. Ord. Piperaceae), a vine of the 
East Indies. The berries are gathered before they are quite ripe, 
cleansed by washing and sifting, and dried in the sun, when they are 
known as shot-pepper. They are wrinkled and black, in consequence 
of the drying of the pulp over the grayish-white seed, and in this state 
are known as black pepper. If permitted to ripen, and soaked in water 
till the outer coat is removed, they constitute white pepper. 

Properties and Constituents. — Pepper has an aromatic, peculiar 
odor and a spicy taste. Its properties are taken up by alcohol and 
ether, and partially by water. It contains a volatile oil, an acrid resin, 
to which the pungent taste of the drug is due, and a crystalline neu- 
tral principle of feeble alkaloidal power called piperin (piperinum) 
(CtfHjgNOg^isomeric with morphia. 

Effects and Uses. — Locally, black pepper is a mild stimulant. 
When pulverized and in contact with the nasal mucous membrane it is 
sternutatory. Its taste is hot and pungent. The effects of pepper are 
similar to those of capsicum. In warm-blooded animals piperin re- 
duces the number of respirations, increases the frequency of the cardiac 
beats (apparently from paralysis of the vagus-centre), dilates the pupils 
widely, and arrests the heart in systole. It is a warm carminative 
stimulant, chiefly employed as a condiment, but it is also useful as a 
stomachic in dyspepsia. 

Administration. — Dose, gr. v-xx. Of the oleoresin (oleoresina 
piperis), the dose is gr. ss-ij, in pill, or capsule. Piperinum (piperin) 
may be prescribed in doses of gr. ij-x. 



:224 MATERIA MEDICA AND THERAPEUTICS. 

CINNAMOMUM— CINNAMON. 

Description, Habitat and Varieties. — There are three official 
varieties of cinnamon — Ceylon cinnamon (Cinnamomum zeylanicinn), 
the inner bark of the shoots of a tree of Ceylon and Java ; China cinnamon 
{Cinnamomum cassia), the bark of the shoots of one or more undetermined 
species of Cinnamomum {Nat. Ord. Laurineae), trees of China; and the U. 
S. P., of 1890, has added Saigon cinnamon {Cinnamomum Saigonicum), 
the bark of an undetermined species of cinnamon, to the list. The most 
esteemed is the Ceylon cinnamon. The greater part of the cinnamon 
brought to this country is the cassia, or Chinese cinnamon. It has the 
general appearance, smell and taste of true cinnamon, but the pieces 
are not doubly quilled. Its properties are identical with those of the 
Ceylon variety. 

Properties and Constituents. — It is found in the shops in long, 
cylindrical pieces, which are very thin and smooth, and of a yellow- 
brown color and a splintery fracture. The constituents of cinnamon 
bark are volatile oil, tannic acid, mucilage, sugar, mannit, etc. 

Effects and Uses. — The cinnamon barks have a fragrant odor 
and a warm, sweetish, aromatic, slightly astringent taste. The oil 
possesses germicidal and antiseptic properties. Cinnamon is an aro- 
matic stimulant t with a slight astringency. It is used chiefly as a carmi- 
native, and as an addition to other medicines. 

Administration. — Dose, gr. x-xxx ; of the tincture (tinctura cin- 
namomi) (Ceylon cinnamon 100 parts, glycerin 50 parts, with alcohol 
and water enough to make 1000 parts of tincture), the dose is foj-iij. 
Oleum cinnamomi (oil of cinnamon) is of a light-yellow, or brownish- 
yellow color, and consists chiefly of cinnamic aldehyde with some cin- 
namyl acetate, dose, gtt. i-ij. Aqua cinnamomi (cinnamon water) is 
used as a vehicle for other medicines. Spiritus cinnamomi (spirit of 
cinnamon) contains 10 parts of the oil dissolved in 90 parts of alcohol, 
dose, gtt. x-xx. Cinnamon enters into a large number of preparations. 

myristica— nutmeg, 
macis— mace. 

Description and Habitat. — The products are portions of the 
fruit of Myristica fragrans (Nat. Ord. Myristicaceae), a tree of the 
Moluccas, cultivated also in Java and Sumatra and other parts of the 
East Indies, and introduced into the isles of France and Bourbon and 
several of the West India islands. It bears a pyriform fruit about the 
size of a small peach, which has a fleshy pericarp, opened by two longi- 



STIMULANTS. 225 

tudinal valves. Within this is the arillus, a scarlet reticulated mem- 
brane, which, when dry, becomes yellow-brown and brittle, and is 
termed mace. The kernels of the seed are the nutmegs. They are 
oval, of the size of an olive, of a grayish-brown color, marked with 
furrows; and to, preserve them from the attacks of an insect, they are 
steeped in a mixture of lime and water. 

Chemical Constituents. — Nutmeg contains a volatile oil (con- 
sisting of pinene)(C l0 H l6 ), myristicin (C 12 H 14 3 ), and a little myristicol 
(C 10 H 16 O), fixed oil (25 per cent), starch, proteids, etc. From mace, also, 
a volatile oil is obtained. 

Effects and Uses. — Mace has a pleasant, aromatic smell and a 
warm, bitterish, pungent taste. Nutmegs have a delightfully fragrant 
odor and a warm, aromatic, grateful taste. Nutmeg is one of the most 
agreeable of the aromatic stimulants, and is much employed for its 
carminative virtues, also as a flavoring ingredient, and to obviate the 
griping effects of cathartics. It possesses some narcotic properties. This 
was exemplified in the case of a child who fell into profound slumber 
after having eaten five large nutmegs.* Mace is chiefly employed as 
a condiment. 

Administration. — Dose of either, gr. xx-xxx. Oleum myristicce 
[oil of nutmeg) is of a pale straw-color, dose, gtt. ij-iij. Spiritus my- 
risticce is made by dissolving 5 parts of the oil in 95 parts of alcohol, 
dose, f5j-ij. The fixed oil of nutmeg is known in the shops as oil of 
mace, adeps myristicce (not official); it is used in liniments. 

CARYOPHYLLUS— CLOVES. 

Description and Habitat. — Cloves are theuNEXPANDED flowers 
of Eugenia aromatica {Nat. Ord. Myrtaceae), an evergreen tree of the 
Moluccas. They are from five to ten lines long, and from one line to 
one line and a half thick, the corolla forming a ball or sphere at the 
top, and the calyx a tapering, somewhat quadrangular base, resembling 
a nail, whence the common name, from the French, clou. 

Properties and Constituents. — When good, they are of a dark- 
brown color, with a yellowish-red tint; they have a strong, fragrant odor, 
a hot, acrid taste, and when pressed with the nail, should give out oil. 
They contain a highly pungent volatile oil, tannic acid, resin, etc., and 
two crystalline principles, termed caryophillin and eugenin ; the oil 
consists chiefly of eugenol (C 10 H 12 O 2 ), with some caryophyllene (Ci 5 H 24 ), 

*N. Y. Med. Jour., Sept. 28, 1889. 
15 



226 MATERIA MEDIC A AND THERAPEUTICS. 

Effects and Uses. — Both the oil of cloves and eugenol are ger- 
micidal. Cloves are among the most stimulating of the aromatics, but 
are used chiefly as a flavoring ingredient and a condiment. The fol- 
lowing combination deadens the pain of toothache, viz : oil of cloves, 
creasote (beechwood), and chloroform, q. s. of each to put on a cotton- 
plug ; to be inserted in cavity of tooth. 

Administration. — Dose, gr. v-x. The oil (oleum caryophylli) is 
pale or yellowish, becoming darker by age, dose, gtt. iij-vj. 

PI MENTA— ALLSPICE. 

Description and Habitat. — Pimenta is the nearly ripe fruit 
of Pimenta Officinalis (Nat. Ord. Myrtaceae), a handsome evergreen 
tree of the West Indies and South America. It comes exclusively 
from Jamaica, and consists of round, brown, roughish berries, rather 
larger than black peppercorns, with an external, hard, brittle shell, 
enclosing two dark-brown seeds. 

Properties and Uses. — They have an aromatic, agreeable smell 
and a strong clove-like taste. They are principally used as a condiment. 

Administration. — The oil (oleum pimentce) has a brownish-red 
color, and consists of eugenol and a sesquiterpene, (QgH^), dose, gtt. 
iij-vj. 

Oleum Cajuputi (Oil of Cajuput). — The volatile oil distilled from 
the leaves of Melaleuca leucadendron (Nat. Ord. Myrtaceae), a tree ol 
the Moluccas, is a powerful diffusible aromatic stimulant, much em- 
ployed in Eastern countries, and of late coming into use in the United 
States. It is a transparent oil, of a fine green color, a lively, penetrat- 
ing odor, analogous to that of camphor and cardamom, and a warm, 
pungent taste. It contains cineol, terpineol, and one or more terpenes. 
It is a remedy for the relief of nausea and intestinal colic, and is added 
as a carminative to purgative pills to prevent griping. Topically it re- 
lieves toothache. Dose, gtt. j-v. 

zingiber— ginger. 
Description, Habitat and Varieties. — Ginger is the rhizome 
of Zingiber officinale (Nat. Ord. Scitamineae), a perennial herbaceous 
plant, growing to the height of two or three feet. Its native country 
is Asia, where it has been cultivated from time immemorial, and was 
early introduced into the tropical regions of America. In the young 
state, the roots are preserved in sugar, and form a very pleasant sweet- 
meat. When old, they are taken up, scalded in hot water, and dried, 
when they are known as black ginger. Sometimes they are scraped 
previously to being dried, and are then called white or Jamaica ginger. 



STIMULANTS. 227 

Properties and Constituents. — Ginger-root occurs in flattish, 
jointed, branched or lobed pieces, which rarely exceed four inches in 
length. Both varieties have a powerful odor. They impart their vir- 
tues to water and alcohol, and contain a pale yellow volatile oil or 
gingerol (to which the hot taste is due), resin, starch, etc. 

Effects and Uses. — Ginger has a warm, pungent aromatic taste. 
It is an aromatic stimulant, much employed as a stomachic in flatu- 
lency, dyspepsia and colic of the stomach and bowels. It is used also 
as a condiment, and to correct the unpleasant taste and nauseating 
qualities of other medicines. A paste made of the powder and warm 
water is used as a counterirritant. 

Administration.- — Dose, gr. x-xx, in pill. The official prepara- 
tions are : tincture (tinctura zingiberis) — dose, f5ss-j ; fluid extract (ex- 
traction zingiberis fluidum) — dose, gtt. xx-xxx ; syi'up (syrupus zingi- 
beris) — used as a vehicle for other medicines ; oleoresin (oleoresina 
zingiberis) — dose, gtt. j-ij, in pill or capsule ; and troches (trochisci 
zingiberis) — (made by mixing the tincture with tragacanth, sugar, and 
a little syrup of ginger); useful in flatulency. 

cardamomum— cardamom. 

Description, Habitat and Varieties. — Cardamom is the fruit 
of Elettaria repens (Nat. Ord. Scitamineae), a perennial plant, from six 
to nine feet high, found in the mountainous parts of Malabar. Three 
varieties of Malabar cardamoms are known in commerce : shorts, 
short-longs and long- longs, all furnished by the same plant. 

Properties and Constituents. — They are ovate-oblong, from 
three to ten lines long, coriaceous, ribbed, and of a grayish or brown- 
ish-yellow color, and contain a number of blackish or reddish-brown 
seeds, which have a pleasant, aromatic odor and an agreeable taste. 
They yield a colorless volatile oil, a fixed oil, starch, etc. 

Effects and Uses. — Cardamom has a warm, aromatic taste, and 
is a very agreeable aromatic, devoid of acridity, and is employed as a 
stomachic and carminative, and as an adjuvant and corrective of other 
medicines. 

Administration. — Dose, gr. v-x. The tincture (tinctura carda- 
momi), (30 parts to diluted alcohol, I OOO parts) is the preparation 
chiefly used, dose, f5j-ij- The compound tincture (tinctura cardamomi 
composita) contains cardamom, and caraway, cinnamon, cochineal, 
diluted alcohol, and glycerin. Free acids separate insoluble carminic 
acid in the latter preparation. 



228 



MATERIA MEDICA AND THERAPEUTICS. 



Pulvis Aromaticus {Aromatic Powder) consists of cinnamon and 
ginger, each 35 parts, and cardamom and nutmeg, each 15 parts. It 
is used as a carminative in doses of gr. x-xxx. 

Extractum Aromaticum Fluidum (Aromatic Fluid Extract) is a fluid 
extract of aromatic powder. It is chiefly used as a flavoring ingredient in 
mixtures, but may be used where aromatic powder is indicated in doses 
of f§ss-j or more. 

CALAMUS-SWEET FLAG. 

Description and Habitat. — The rhizome of Acorus calamus 

Fig. 18. 




ACORUS CALAMUS : RHIZOME. 



{Nat. Ord. Aroideae), an indigenous marshy plant, with long, sword- 
shaped, radical leaves (giving out a delicious fragrance when rubbed). 



STIMULANTS. 



229 



Properties and Constituents. — The rhizome is found in the 
shops in somewhat flattened pieces, deprived of their epidermis, 
wrinkled, and of a yellowish color, and has a strong, fragrant odor and 
a warm, bitterish, aromatic taste. It contains volatile oil, acorin (prob- 
ably a glucoside), resin, starch, etc. 

Effects and Uses. — It is an aromatic stimulant, with some tonic 
properties. According to Cadeac and Meunier,* the essential oil has 
a special affinity for the nervous system, being a powerful convulsive 
and tetanizing agent and dangerous when mixed with liquors. 

Administration. — Dose, gr. xx to 5j. K fluid extract [extraction 
calami fluidunz) is official, dose gtt. xx-f 5i ; or it may be given in in- 
fusion. 

gaultheria— partridge berry. 

Description and Habitat.— Gaultheria procumbens (not offi- 
cial),Wintergreen, or Teaberry {Nat. Ord. Ericaceae), is a small indigenous 
evergreen plant, with reddish stems, a few inches in height, bright-green 
leaves, and white, ovate, five-toothed flowers, followed by scarlet berries. 

Portion Used and Constituents.— The leaves are the medicinal 



Fig. 




GAULTHERIA PROCUMBENS. LEAVES. 

portion, and contain a very stimulating volatile oil {oleum gaultherice) y 
* Compt. Rend. Soc. de Biol., Ser. 9; Paris, 1890, p. 509. 






230 MATERIA MEDICA AND THERAPEUTICS. 

of an aromatic odor, and a sweetish, warm taste, which, when first 
distilled is colorless, but gradually becomes reddish, and is distin- 
guished as being the heaviest of volatile oils. It consists of to part 
of an undetermined body, and methyl salicylate (methyl salicylas) 
(CH 3 C 7 H 5 3 ), A parts. Methyl salicylas is termed by the U. S. P. of 
1890, artificial oil of wintergreen. It is a colorless or yellowish liquid, 
possessing the odor and taste of the oil of gaultheria. Volatile oil of 
Bctula (oleum betidce volatile}, obtained from the bark of Betula lenta, 
or Sweet Birch {Nat. Ord. Betulaceae), is identical with and consists 
entirely of methyl salicylate. The leaves also -contain arbutin, ericolin, 
tannin, sugar, etc. 

Toxicology. — Dr. Pinkham * reports four cases of poisoning by 
oil of gaultheria, in which f Sss was the fatal dose in each. In all 
severe symptoms of irritation of the gastro-intestinal tract and dis- 
turbance of the cerebral functions were noted. It seems to be a nar- 
cotico-irritant poison. 

Effects and Uses. — Locally, the oil of gaultheria is stimulant and 
antiseptic. It possesses antipyretic powers about equal to those of 
sodium salicylate, and it has been used for this purpose with con- 
siderable success in acute rheumatism. Dr, Kinnicutf reports twelve 
cases treated by it with the following results : Complete absence of 
pain in about three days; duration of fever, 3^ days ; average stay 
in hospital, 24^ days. Gottheil % finds it reduces the local swelling 
and relieves the pain (four cases) ; while A. Flint, Sr.,§ states that the 
average length of confinement to hospital was in eleven cases, less 
than five days — a very favorable showing. All of these observers gave 
it in frequently repeated doses (gtt. x), Flint in flaxseed tea. 

Administration. — The official preparations are the oil (oleum 
gaidtherice), and the spirit (spiritus gaidtherice), containing 50 parts of 
the oil in 950 of the preparation, dose of the oil, TVL v-x, in capsule ; 
of the spirit, f5ss-j. An infusion of the leaves is in very general 
popular use as a carminative and stomachic. 

AURANTII AMARI CORTEX— BITTER ORANGE-PEEL. 
AURANTII DULCIS CORTEX— SWEET ORANGE-PEEL. 

Description and Uses. — The rind of the fruit of Citrus vulgaris, 
or Bitter Orange, and Citrus aurantium, or Sweet Orange, the rind of 

* Boston Med. and Surg. Jour., Dec. 8th, 1887. 

f N. Y. Med. Record, 1882, p. 505. % Ibidem, 1883, p. 256. § Ibidem, 1883, p. 725. 



STIMULANTS. 231 

the fresh fruit (Nat. Ord. Auranticeae), is much employed as a flavoring 
addition to other medicines. 

Chemical Constituents. — They contain volatile oils, hesperidin (a 
bitter crystalline glucoside), etc. The flowers yield a delightful volatile 
oil (oleum aurantii florum), termed oil of neroli, consisting of limonene, 
nerolol (C 10 H 18 O), nerolyl acetate and geraniol. 

Administration. — The following are the official preparations : 
orange-flower water (aqua aurantii florum), and (aqua aurantii florum 
fortior), stronger orange- flower water, agreeable vehicles possessing 
slight antispasmodic virtues ; syrup of orange-flowers (syrupus aurantii 
florum), and syrup of orange .(syrupus aurantii} are used as excipients 
and vehicles for medicines of unpleasant flavor ; oil of orange-peel 
(oleum aurantii corticis) (TTUj-v), fluid extract of bitter orange-peel (ex- 
tractum aurantii amari fluidum) (f-5j), spirit and compound spirit of 
orange (spiritus aurantii) and (spiritus aurantii compositus) (f5ss-j), 
aromatic elixir (elixir aromaticum), containing compound spirit of 
orange, a recent addition to the U. S. P. The tincture of bitter orange- 
peel (tinctura aurantii amari), and tincture of sweet orange-peel (tinc- 
tura aurantii dulcis) may be given in doses of f5j-ij. 

The following aromatics, of the natural order, Labiate, are 
pleasant carminatives and stomachics : — 

Lavandula (Lavender) (not official). — The flowers of Lavandula 
officinalis, a small European shrub, cultivated in our gardens, about 
two feet high, with fragrant blue flowers, which are gathered in June, 
and dried in the shade. They have an agreeable fragrant odor and a 
pungent, bitter taste. They contain volatile oil, resin, a little tannin, 
etc. The oil (oleum lavdndulce florum), which is of a pale-yellow 
color, may be used in the dose of from gtt. j-v. It has antiseptic 
properties. The preferred preparations are the spirit (spiritus lav- 
andulce) dose, Tft xxx to lx, and the compound tincture (tinctura lavan- 
dulce compositd), which contains also oil of rosemary, cinnamon, cloves, 
nutmeg, and red saunders ; dose, f 5j. 

Mentha Piperita (Peppermint) and Mentha Viridis (Spearmint) 
are European plants, naturalized in the United States. The leaves 
and tops are employed ; they have an aromatic odor and a pungent, 
somewhat bitter taste, followed by a sensation of coolness. Mentha 
viridis contains a volatile oil, gum, resin, etc. ; Mentha piperita,* a 
volatile oil of complex composition, which has been found to contain 

* Pharm. Rundschau, N. Y., July, 1894, Power and Kleber. 



232 MATERIA MEDICA AND THERAPEUTICS. 

the following bodies : acetic and valerianic aldehydes, acetic and valeri- 
anic acids, piueue, phellandrene, limonene, cineol, menthone (C 10 H 18 O), 
menthol (C 10 H 20 O), the acetic and valerianic esters of menthol, cadinene 
(Ci 5 H^), and a lactone (C 10 H 16 O 2 ). 

Menthol {Mint- Camphor ', a stearopten), (C 10 H 19 OH) is obtained by 
the fractional distillation of the essential oils of various species of 
mentha, and to it the oil owes its peculiar odor. It occurs in colorless 
prisms, soluble in oils and alcohol. It is decidedly analgesic, and also 
antiseptic. It has, of late years, been extensively used as an anodyne 
application in the treatment of neuralgic pains, especially those occur- 
ring in the supra orbital and temporal .regions, as headache, but is 
equally efficient in neuralgias affecting other regions. It is also 
recommended for the relief of rheumatic pains. As an antipruritic in 
eczema and pruritus generally, it is applied in alcohol gr. ij^-xto 
^y 2 ', or in olive oil and lanolin. It is found in the shops in cones or 
pencils under the name of Menthylene, etc., but the best preparation 
for external use is a solution in alcohol (5 j of the pure crystals to 
f §ss) painted over the part with a brush. Menthol gr. ij to liquid 
petroleum f oj is used as a spray in acute nasal catarrh. 

A. Rosenberg* uses menthol 20 parts to ether 100, or 50 of 
alcohol, as a substitute for cocaine to produce local a?tcesthesia of the 
nasal cavities and pharynx. He finds that it induces anaemia of the 
mucous membrane and diminution of sensibility. Burney Yeo advises 
to prevent the itching about the pustules of> small-pox the following : 
menthol 3, camphor 2, and vaseline 20 parts. M. 

Braddon f has called attention to the antiseptic properties of 
peppermint oil, and he experimentally found it (up to 1 to 3000) to be 
superior, in the prevention of decomposition, to such agents as corro. 
sive sublimate and carbolic acid. For minor surgical operations he 
used successfully gtt. j to olive oil fSj soaked in lint. In this form it 
is packed into sinuses, and suppurating buboes, and applied to ?dcers, 
and rupia, being retained by a strip of rubber plaster. The results 
obtained by him with the inhalation of the pure oil, as a germicide in 
phthisis, are scarcely conclusive, though in some cases it seemed to be 
beneficial. 

Administration. — The oils (oleum mejithce piperita and viridis) 
may be given in doses of gtt. v-x : useful in flatulent dyspepsia, given 

* Central, filr gesa?nt. therap., Oct. 1886, p. 441. 
\ The Lancet, March, 1888, pp. 512, 567. 



STIMULANTS. 233 

after meals. Two waters are official {aqua menthce piperita 'and aqua 
menthce viridis), both much used as vehicles. The oil of peppermint 
is the stronger of the two oils, and is strongly recommended as an 
anodyne application in allaying the neuralgic pains of herpes zoster* 
Troches of peppermint (trochisci menthce piperitce) are made by rubbing 
up oil of peppermint with sugar and mucilage of tragacanth, useful in 
flatulency. Spiritus menthce, piperitce contains peppermint and oil of 
peppermint dissolved in alcohol, dose, Tit x-xx ; spiritus menthce viridis, 
oil of spearmint and spearmint in alcohol, dose, TTL xxx-xl. 

Hedeoma [Pennyroyal). — Hedeoma pulegioides, or Pennyroyal, is 
an indigenous annual plant, about a foot high, with oblong lanceolate, 
serrated leaves, and small, pale-blue flowers arranged in axillary whorls. 
The leaves and tops are used, which contain a light-yellow essential 
oil {oleum hedeoma), dose, TTL ij-x, similar in properties to the mint-oil, 
but somewhat more powerful. Kremers f has found the oil to contain 
two ketones of the composition C 10 H 18 O, also pule gone (Ci H 16 O), and 
formic, acetic and iso-heptoic acids. 

Marrubium (Horehound). — Marrubium vulgare possesses mild, 
stimulant, tonic and expectorant properties, and, in large doses, proves 
laxative. It is used chiefly in cough syrups and candies. The leaves 
and tops are employed. 

Salvia (Sage). — The leaves of Salvia officinalis, a European plant, 
cultivated in our gardens, are used as a condiment, and may be given 
in infusion as a gargle in pharyngitis ; they are slightly tonic and 
astringent, as well as aromatic. It is an ingredient of vinum aro- 
maticum. 

Oleum Thymi (Oil of Thyme). — The volatile oil distilled from the 
Thymus vulgaris is often substituted for oil of origanum, and is used 
as an external application. The oil of thyme (oleum thymi) is germi- 
cidal, and consists of cymene (C 10 H 14 ), thymene (Ci 6 H 16 ), and thymol 
(C 10 H 14 O), the latter occurring in highly aromatic colorless crystals, 
and it has been found a valuable antiseptic and antifermentative agent 
(see index) ; dose, Vfl ij-v. 

The following aromatic seeds are derived from plants of the natural 
order Umbellifer^e, except Illicium : — 

Faenicuium (Fennel). — The fruit of Fceniculum capillaceum, a 
European plant, cultivated in our gardens. It may be used in infusion ; 



* The Practitioner, London, August, 1882, Meredith, 
f Proc. Amer. Pharm. Assoc, 1887, pp. 546, 561. 



234 MATERIA MEDICA AND THERAPEUTICS. 

the dose of the oil (oleum foeniculi) is gtt. v-xv. Fennel-water (aqjia 
foeniculi) is official, dose, f§ss— ij. 

Carum (Carazvay). — The fruit of Carum Carvi, a European plant, 
cultivated in this country. Dose of the oil {oleum cari), gtt. j-x. 

Anisum (Anise). — The fruit of Pimpinella anisum, cultivated 
throughout the south of Europe. Dose of the oil (oleum anisi), gtt. 
v-xv. Anise-water (aqua anisi), dose, fS^-ij, and spirit of anise (spiritus 
anisi) , dose, foi-ij, are also official. 

Coriandrum (Coriander). — The fruit of the Coriandrum sativum, 
an annual plant of the south of Europe. The oil (oleum coriandri) is 
official, dose, Til ij-v. 

Illicium (Star Anise). — The fruit of the Illicium verum (Nat. Ord. 
Magnoliaceae), an evergreen tree of China and Japan is official. It 
contains a volatile oil (which is chemically identical with the oil of 
anise, but has a slightly different odor and taste), fat, resin, etc. (Maisch). 
The oil possesses analogous properties to those of the oil of anise, and 
is much used as a substitute for it 

vanilla. 

Description and Habitat. — This is the fruit of Vanilla plani- 
folia (Nat. Ord. Orchideae), a climbing plant of Cuba and Mexico, 
cultivated also in various parts of tropical America, in the Mauritius, 
Reunion and Java. 

Properties. — The pods, when gathered, are yellow, but by ex- 
posure to the sun they assume a dark copper color. They are cylin- 
drical, somewhat flattened, wrinkled, six or eight inches long, three or 
four lines thick, and contain a soft black pulp, in which numerous small 
black seeds are embedded ; the interior pulpy portion is most aromatic. 

Chemical Constituents. — The odorous principle of vanilla is a 
crystalline substance termed vanillin (C 8 H 8 3 ), which can be made 
synthetically from coniferin ; it is found only in the interior and not in 
the exterior fleshy portion. 

Effects and Uses. — Vanilla has a strong characteristic, highly 
pleasant odor, and a warm, aromatic, sweetish taste. It is a mild dif- 
fusible stimulant, chiefly used, however, as a perfume and flavoring in- 
gredient. 

Administration. — The tincture (tinctura vanillce) is official, dose, 
f5i-ij. 

OLEUM BERGAMOTT^E-OIL OF BERGAMOT. 

Description. — This is a volatile oil obtained by expression from 
the rind of the fresh fruit of Citrus Bergamia (Nat. Ord. Rutaceae). 



SEDATIVES— ACONITE. 235 

Properties. — A greenish-yellow liquid of peculiar and very fra- 
grant odor and aromatic taste. 

Uses. — For flavoring purposes, and in preparing cologne waters. 

ORDER VII.— SEDATIVES. 

Sedatives are medicines which diminish the frequency and force 
of the circulatory apparatus. They are employed therapeutically to 
reduce excitement of the vascular system. 

With sedatives may be included also the medicinal agents termed 
refrigerants, comprising nearly all the neutral alkaline salts, as well as 
those in which the acid predominates, and the vegetable acids. These 
substances have little power of diminishing the ordinary or healthy 
temperature; but they lower febrile heat, allay thirst, restore the 
secretions, and in this way are very useful adjuvants in the treatment 
of febrile complaints. 

ACONITUM-ACONITE. 

Description, Habitat and Properties. — Aconitum Napellus 
Aconite, Wolfsbane, or Monkshood {Nat. Ord. Ranunculaceae,) is a 
native of the mountainous parts of Europe and Asia. The tuber is 
the official portion. It is brought from Europe, India and Japan, and 
other species of Aconitum than A. Napellus furnish some of the aconite 
of commerce. The tuber is conical and tapering with the rootlets 
attached. Its properties are impaired by long keeping, when the plant 
loses its medicinal efficacy. 

Chemical Constituents. — The active principle of aconite is an 
alkaloid named aconitine (C^H^NO^). Four other alkaloids, viz., 
pseudaconitine (C 36 H 49 NO n ), aconine (C 26 H S9 NO u ), pseudaconine (C 27 H 41 
N0 8 ), and picraconitine (C 31 H 45 NO 10 ), have been found in it, but the 
chemistry of aconite is not well settled. Wright and Luff* isolated 
from the roots of Japanese aconite only one alkaloid, japaconitine, 
which can be split into japaconine, both of which closely resemble 
aconitine and aconine in physical properties. 

Chemistry and Tests. — Aconitine exists in combination with a 
peculiar acid termed aconitic, and is prepared from an aqueous solution 
of an alcoholic extract of aconite root, by the addition of sulphuric 
acid (which converts the natural salt of aconitine into a sulphate). It 
is a white amorphous powder, with a tinge of yellow (though it has 
been obtained in crystals), without smell, of a bitter, acrid taste, and 

* Journal of Chemical Society, vol. I, p. 387, 1879. 



236 



MATERIA MEDICA AND THERAPEUTICS. 



produces in the mouth a sense of numbness. It is partially soluble 
in water, and is readily dissolved by alcohol and chloroform, less 
readily by ether. There is no characteristic chemical test for aconitine, 
but a strong aqueous solution of hydrobromic acid saturated with 
bromine throws down the aconite salts, or aconite itself, as a yellow 
precipitate, even if it be present in minute quantity (Tshin, Wormley). 
In medico-legal cases, the physiological test, by producing numbness 
and tingling of the lips or skin, must be resorted to. As aconitine is 
easily decomposed, the commercial article is more or less impure. 

Aconitine is an exceedingly virulent poison, more powerful when 
pure than hydrocyanic acid. It is scarcely adapted to internal use, 

Fig. 20. 




ACONITE-ROOT. 

as even gr. 5 V nas produced alarming results. Morson's aconitine 
prepared from the cultivated A. Napellus, is terribly potent, even 
gr. toVo producing numbness of the tongue. 

Aids. — Veratrum viride, veratria, cold, quinine, pulsatilla, Phyto- 
lacca and cardiac depressants generally. 



SEDA TIVES—A CONITE. 237 

Contraindications. — Debility of the circulatory apparatus; car- 
diac valvular lesions with regurgitation. 

Physiologial Effects. — Aconite applied locally causes a sensa- 
tion of numbness and tingling, induced by its benumbing effect on the 
sensory nerves. The following account of the action of aconite is 
based on the investigations of Mackenzie,* Laborde et Duquesnel,f 
and of Plugge.J Its taste is bitterish and acrid, and when chewed 
occasions a feeling of tingling and numbness in the interior of the 
mouth. Within the stomach small doses are without obvious local 
effect; full, produce a sense of warmth and tingling with nausea. 
After absorption in sufficient quantity a general sensation of tingling 
is experienced. Secretions: aconite increases the secretion of the 
skin, salivary glands and kidneys. Nervous system ; aconite taken in 
small doses exerts no influence upon the cerebrum, and has no 
action upon the motor-nerves, the loss of reflex action caused by it 
being due to paralysis of the sensory end-organs, extending to the 
nerve-trunks, and finally to the spinal sensory centres. The spinal 
motor-centres are only involved when total palsy has set in. Circula- 
tion : aconite exerts a marked influence on the circulatory apparatus, 
small doses reducing the heart's action and lowering the arterial 
pressure ; lethal doses stop the heart in diastole. Aconite applied to 
the heart slows it so that it may be concluded the drug is a cardiac 
poison acting directly on its motor ganglia. It is also believed to 
stimulate the cardiac inhibitory apparatus. According to the researches 
of Ringer and Murrell, aconite paralyzes all nitrogenous tissues, and 
it is in this way that the heart's beats are retarded. In other words, it 
acts directly against the heart's contained motor-apparatus. Respira- 
tion: these movements tend to become slow, and the temperature is 
lowered. Elimination : it is probably eliminated by the kidneys. 

Toxicology. — In lethal doses, its effects are those of an acro- 
narcotic poison, the symptoms being a burning or benumbing sensa- 
tion in the mouth, throat, and tongue, followed by gastric irritation, 
spasmodic purging, short, shallow, and superficial respirations, con- 
traction or expansion of the pupils, though dilatation is the rule ; 
numbness or paralysis of the limbs ensues, the skin is cold and 
clammy, convulsions set in, the pulse fails, and death results from 
syncope. Aconitized animals remain conscious until death takes 

* The Practitioner, xx, 1 878, pp. IOO, 185. 
f Revue de Med., iii., 1883, p. 804. % Ibidem,^. 1045. 



238 MATERIA MEDIC A AND THERAPEUTICS. 

place. In several instances a drachm of the tincture has destroyed 
human life. 

Antidotes. — In case of poisoning, the stomach is to be thor- 
oughly evacuated, and cardiac stimulants, externally and internally, are 
to be freely administered. The object of physiological antidotes being 
to keep the heart acting, hypodermics of atropine sulphate and aqua 
ammoniae will be found powerful excito-motors for this purpose. 
Digitalis is advised by Fothergill. 

Medicinal Uses. — Aconite is a powerful remedy in the treatment 
of neuralgic?, especially when the 5th pair of cranial nerves are affected. 
It is often combined with quinine in these cases, and should be given 
in doses sufficient to produce its characteristic physiological effects to 
a slight degree. A local application of the tincture or of the liniment 
or ointment is often resorted to with advantage, while the drug is 
administered internally. 

From its influence on the circulation it is applicable to those 
cases of inflammation in which general bloodletting was formerly 
resorted to with advantage, as it slows the pulse-rate and lowers the 
arterial tension, at the same time reducing the temperature and causing 
diaphoresis and diuresis. 

Thus it is applicable in all cases of sthenic inflammatory fever, 
occurring in robust young adults with a full, tense, bounding, strong 
and frequent pulse, and does most good before the effusion of inflam- 
matory products has taken place. It is not so efficacious, however, 
in typhoid conditions of the system, where the heart is weak or where 
there exists acute inflammation of the gastro-intestinal mucous mem- 
brane. 

Its timely administration may be of much service to control 
cardiac action in apoplexy and so prevent further haemorrhage ; to 
calm or hold in check the circulatory apparatus in vascular excitement 
and congestion, as that of throbbing headache, hcemoptysis, pulmonary 
congestion, etc., and to be beneficial in these conditions it should be 
given in doses large enough to make its influence felt. It is likewise 
given to control the heart early in endocarditis. 

In surgical fever it is better given in small doses, frequently 
repeated until its effects on the pulse are manifested, when the interval 
between the doses should be increased, and it may be administered 
either alone or combined with other remedies, as in the following fever 
mixture : ^ Morphinae sulphatis, gr. j-ij ; tincturae aconiti, Tltxxiv ; 
potassii acetatis, Sss; spiritus aetheris nitrosi, £5vj ; liquoris ammonii 



SEDA TIVES—A CONITE. 239 

acetatis, f§iss; syrupus limonis, ad fSiij. M. S. — f5j in water every 
2, 3 or 4 hours as indicated. 

Aconite may be prescribed in this way and for these effects, not 
only in surgical fevers but also in idiopathic inflammatory conditions, 
provided the indications for its employment are present. In acute ton- 
sillitis it will not infrequently cut short the attack if administered in 
time ; in acute pharyngitis, acute laryngitis or acute bronchitis, it is of 
undoubted value when given early, in small doses and frequently 
repeated. An incipient nasal catarrh may be aborted by the timely 
use of aconite, given as above, until the pulse is reduced in volume 
and frequency, although for this purpose veratrum viride is generally 
preferred. In the early stages of acute otitis media, if the circulation 
be excited, much relief may be obtained by a combination of aconite 
with morphine and potassic bromide, and the external application ot 
heat. In certain diseases of the respiratory organs, aconite is of great 
value, not only from its action on the circulation, but because it slows 
the respiratory act. Thus in acute pleurisy before the stage of effusion 
has been reached, if the patient be strong and robust and the pulse 
full and bounding, tincture of aconite gtt. j should be given every 15 
or 20 minutes, until the pulse is influenced, while morphine (gr. l-i) 
should be administered hypodermically, and wet or dry-cups freely 
applied to the affected side, followed by a large poultice. 

In acute catarrhal pneumonia aconite is also beneficial, and even 
in the first stage of lobar pneumonia it may be cautiously administered 
combined with some of the ammonium salts, but it must be discon- 
tinued as soon as effusion has taken place. It possesses no advantage 
over veratrum viride in these cases, and the latter is probably the safer 
remedy. 

In phthisis, when the disease tends to spread, it may be given 
cautiously, to reduce the pulse-rate and moderate the fever. 

In acute perito?iitis aconite is of value and should be combined 
with large doses of opium. In those forms of peritonitis occurring 
during the puerperal period and due to septic infection, aconite is con- 
traindicated, a supporting and antiseptic plan of treatment giving 
better results (see puerperal septicaemia, under quinine). 

In acute cerebral or acute spinal meningitis aconite is of great 
value in controlling the circulation. It is indicated in many of the 
essential fevers, as in febricula, in which disease a fever mixture con- 
taining aconite, and the administration of small doses of calomel, 
frequently cut short the attack. 



240 MATERIA MEDICA AND THERAPEUTICS. 

To moderate the excessively rapid pulse of scarlet fever as well as 
for its antipyretic, diaphoretic and diuretic action, aconite is of the 
greatest utility. In sthenic cases of medical erysipelas it has been 
advantageously prescribed. 

In the early stages of cerebrospinal meningitis before exudation 
has taken place, it may be given with large doses of opium and 
potassic bromide, while the local abstraction of blood by leeches, 
followed by cold to the head and neck is employed. 

To moderate the fever and pulse in the hot stages of intermittent 
and remittent fever, aconite is also used, and in the latter affection it 
is often efficacious in relieving the intense headache which so frequently 
accompanies this stage. 

From its effects on the heart itself aconite is of the greatest value 
in cases of cardiac hypertrophy when not compensatory to valvular 
lesion. In cases of simple hypertrophy, palpitation and over-action, it 
is our most available remedy combined with rest in the recumbent 
posture, but should any valvular disease exist, great caution must be 
exercised in prescribing it. In cerebral hyperemia of active type, by 
diminishing the force and frequency of the cardiac contractions, it 
proves most beneficial. 

It is of some service in the treatment of internal aneurism as a 
cardiac sedative. 

As a topical anodyne, aconite, as might be inferred from its local 
benumbing action, is a most useful remedy in neuralgia? and chronic 
rheumatism, either painted over the part in the form of a tincture or 
applied as a liniment or ointment, and sometimes when thus used it 
has a marked beneficial effect. Admixture with chloroform aids the 
absorption of its alkaloid, and thus enhances its effect; but when thus 
used it should be employed with care and not applied to too large a 
surface for fear of too rapid absorption.* 

Aconitine has been used internally and locally in the treatment of 
tic douloureux and other forms of trigeminal neuralgia. Duquesnel's 
aconitine is preferred for internal administration in doses of tto-tio. 
It is a very active poison, and if employed at all, should be used with 
the greatest care. 

Topically, it is employed in neuralgia?, as sciatic, or facial, in alco- 
holic solution (gr. j-ij to alcohol f5j), or as an ointment (gr. ij to lard 5j, 



* " A Text-Book of Pharmacology, Therapeutics and Materia Medica." By T. Lauder 
Brunton, M. D., etc. London: 1885^.753. 



SEDATIVES— VERATRUM VIRIDE. 241 

rubbed up with alcohol gtt. vj) ; applied over the vertebrae in spinal 
irritation. When applied to the temple or brow great care should be 
exercised to prevent any from coming in contact with the conjunctiva, 
as absorption from the membrane is very rapid and may occasion 
poisoning. 

Administration. — The dose of the powdered root is gr. % to ]\ 
of the fluid extract [extractum aconiti fluidum) Tft l-iij ; of the extract 
{extraction aconiti) (alcoholic), gr. %-% ; of the tincture (tinctura 
aconiti), which is by far the best preparation (350 parts of the powder 
are contained in 1000 parts of the tincture), TTL %— v. These doses 
are to be repeated twice or thrice daily, and cautiously increased till 
the effects of the medicine are apparent, or in acute febrile affections 
the smaller doses may be given and repeated every 15 to 30 minutes 
until the pulse is influenced or diaphoresis occurs. The tincture may 
be used externally. 

VERATRUM VIRIDE-AMERICAN HELLEBORE. 

Description, Habitat and Properties. — Veratrum viride, known 
as Swamp Hellebore, Poke-root, Indian Poke, etc., (Nat. Ord. Liliacese), 
is a swampy plant, indigenous to the eastern portion of the United 
States, growing to the height of from three to six feet. The rhizome 
and root are the official portions. The rhizome is an inch or two in 
length, thick and fleshy, with numerous yellow rootlets, and is found 
usually in the shops in slices or fragments, externally of a blackish 
color and internally of a dingy-white color. It is inodorous, but has 
a bitter, acrid taste, which leaves a permanent impression on the mouth 
and fauces. For use, attached portions of the dried stem should be 
rejected, as they are inert. 

Chemical Constituents. — C. L. Mitchell's* analysis of the rhi- 
zome shows it to contain veratroidine -d,no\jervine (the latter found also 
in V. album), rubijervine, pseudojervine, with resin and oily matter. 
Some authorities state that it contains also veratrine (Wormley), but 
this is still an open question. Veratroidine is a white, uncrystallizable 
powder, of a bitter taste, leaving a tingling sensation in the fauces, 
soluble in alcohol, ether and chloroform. Jervine is a white, tasteless 

* Proceedings Am. Pharm. Associat., 1874, p. 397. 

According to Wright and Luff 1 the alkaloids of veratrum viride are essentially jervine, 
pseudojervine, cevadine, with a trace of veratrine and veratalbine, cevadilline being absent ; 
of veratrum album, pseudojervine, jervine, veratalbine, rubijervine and veratrine (a trace). 



1 yoitrnal of Chemical Society, Vol. I, 1879, p. 405. 
16 



■24'2 MATER/A MEDICA AND THERAPEUTICS. 

powder, which crystallizes from an alcoholic solution, insoluble in water 
and ether, and freely soluble in alcohol and chloroform. 

Aids. — Upon the heart, aconite ; its emetic action is favored by 
ipecacuanha. 

Contraindications. — The preparations of veratrum viride should 
only be given to strong, robust patients, and rarely made use of in 
any asthenic malady, or in cardiac valvular disease. 

Physiological Effects. — Veratroidine is emetic, and sometimes 
cathartic, and a depressant to the circulation. Gastro-intestinal tract : 
veratroidine is an irritant, causing violent vomiting and purging in 
poisoned animals. Nervous system : in animals poisoned by veratroi- 
dine, twitching and finally convulsions are produced ; the reflex spinal 
centres are at first depressed, afterward paralyzed. Circulation : ap- 
plied directly to the heart, it paralyzes the cardiac muscle. Whenv 
given hypodermically* to animals, it at first lessens the rapidity of the 
pulse and lowers the arterial pressure (due to stimulation of the inhi- 
bitory nerves) ; soon, however, the heart's beat becomes greatly in- 
creased in force, but not in frequency, and the blood-pressure falls to 
normal ; then suddenly the pulse becomes very rapid, and the cardiac 
force is lessened (due to peripheral paralysis of the inhibitory nerves), 
and the tension rises much above the normal (caused by increasing 
asphyxia). Respiration : in animals poisoned by veratroidine, death is 
caused by asphyxia, due to paralysis of the respiratory muscles. 
Muscular system : great muscular weakness has been noted in poi- 
soned animals. 

Locally, jervine is a feeble irritant. It produces general weakness 
(without, however, vomiting or purging), lowering of arterial pressure 
and slowness of the pulse, profuse salivation and finally convulsions. 
Nervous system : the effects of jervine are similar to those of vera- 
troidine, but, in addition, the vaso-motor nerves are paralyzed. Circu- 
lation ; f when applied directly to the heart of the frog, it paralyzes it. 
When a warm-blooded animal is poisoned with jervine, the frequency 
of the pulse is diminished, and the arterial pressure falls greatly, due 
to the direct action of the drug on the cardiac muscle, as well as to 
paralysis of the vaso-motor centres. Respiration : death takes place 
from asphyxia. 

The effects of veratrum viride are similar to those of its two 
alkaloids described above. It is an active local irritant. Taken inter- 

* PhUa. Med. Times, Vol. IV. H. C. Wood. f Ibid - 



SEDATIVES- VERATRUM VIRIDE. 



243 



natty, it sometimes promotes the flow of urine, and in doses of about five 
grains proves emetic. In continued doses it produces a marked seda- 



FIG. 20. 




VERATRUM VIRIDE. 



244 MATERIA MEDICA AND THERAPEUTICS. 

the action on the circulation, irrespective of the nausea induced, which, 
indeed, may be prevented by careful administration, and the tempera- 
ture of the body is much lowered. It has not generally proved laxa- 
tive. 

Toxicology. — A few fatal cases are recorded from its use — though 
stimulants almost invariably counteract any excessive sedation. Re- 
covery has taken place after f Sj of the tincture had been swallowed, 
while f5j of the tincture has destroyed life,* and in another case f 
about Tftxxx proved fatal. 

Medicinal Uses. — Veratrum viride is used principally as a car- 
diac and vaso-motor depressant. In pneumonia, in which the danger is 
chiefly from failure of cardiac power, the use of veratrum requires 
caution and is serviceable only in the early stage before exudation 
has taken place. It is also serviceable in cardiac affections, as over- 
action of the heart, or hypertrophy unaccompanied by valvular disease, 
and to moderate vascular excitement. In active hemorrhage and in 
acute congestions generally it is also of- value as a sedative. It has 
been recommended in puerperal eclampsia, \ on account of its depress- 
ing influence on the reflex centres of the cord (Fordyce Barker, Boyd, 
N. L. Guice, etc.) ; it should be given in doses sufficiently large to re- 
duce the pulse to 60 or 80 beats per minute, and this effect carefully 
maintained. A few drops of the tincture repeated every hour or two, 
according to the condition of the pulse, may abort an ordinary " cold 
in the head," if given early enough. 

Administration. — Dose, of the powder, gr. j-ij to begin with ; of 
the tincture (tinctura veratri viridis), gtt. v-x ; of the fluid extract (ex- 
traction veratri viridis fluidum), gtt. iv-v. 

Veratrina (Veratrine) (C 3 2H52N 2 8 ) is a mixture of alkaloids ob- 
tained from the seeds of Asagraea officinalis (Nat. Ord. Liliacese), a 
herbaceous plant of Mexico, which contains no jervia.% 

Preparation and Properties. — It is made by evaporating a strong 
tincture of the seeds to the consistence of an extract, from which the 
alkaloid is dissolved by diluted sulphuric acid ; and afterward precipi- 
tated by magnesia. When pure it is white, but it is usually a grayish 
or brownish-white powder, without odor, but very irritant to the 
nostrils, and of an acrid taste ; scarcely soluble in cold water, but 



* Med. Times, Aug. 1884, p. 863. 

I Med. and Surg. Reporter, May, 1873, p. 379. 

% Canadian Practitioner, March, 1885, p. 366. 

$ Proceed. Am. Pharm. Associat., 1874, P- 397- C. L. Mitchell. 



SEDATIVES— VERATRUM VIRIDE. 245 

readily soluble in alcohol, and of an alkaline reaction. A delicate test 
for veratrine is Trapp 's — a permanent lilac-red color, resembling a 
solution of potassium permanganate, afforded by boiling it in hydro- 
chloric acid. 

Physiological Effects. — Locally, veratrine acts as an irritant,* 
producing heat, pain, and numbness in the part to which it is applied. 
Its taste is acrid, producing a sense of tingling or numbness on the 
tongue. Gastro-intestinal tract : in large doses it is an irritant poison, 
causing severe vomiting and purging, f Nervous system : its action 
on the brain is not marked, and the reflex excitability of the spinal 
cord is diminished in animals after the administration of a large dose 
(Ott). Veratrine acts as a direct poison upon nerves (Ott, Wood H. C, 
etc.), but whether it affects the nerve-trunk or its end-organs is still 
sub judice. Circulation and blood : in animals, small doses stimulate 
the excito-motor cardiac ganglia and increase the frequency of the 
cardiac beats ; large doses stimulate the pneumogastric nerves, and as 
the excito-motor ganglia become exhausted, the cardiac beat is slowed. 
It also poisons the cardiac muscle. It probably paralyzes the central 
vaso-motorj apparatus eventually. The blood pressure is, at first, 
elevated, then lowered, and the blood is rendered less coagulable. 
Respiration and temperature : small dozes increase, while larger doses 
diminish, the frequency of the respiratory movements, and the tem- 
perature is lowered. It destroys life by paralysis § of respiration. 
Secretion : the secretions from the skin and kidneys are increased. 
Muscular system : || muscular irritability is at first exalted (producing 
convulsions), but is afterwards entirely lost. Heat If increases and 
cold lessens the effects of veratrine on muscle. Elimination : by the 
kidneys. 

Toxicology. — Its toxic action is comparable to that of its con- 
geners. Stimulants and ethereal inhalation would be the proper 
treatment in cases of poisoning. 

Medicinal Uses. — Veratrine is rarely prescribed internally ; the 
dose is gr. fu to \ repeated ; it is chiefly used topically, in the form of 
ointment (itnguentum veratrince} (4 parts, to alcohol 6 parts, and ben- 

* Bull. Gen. de Therapy cv, 430. Sur Taction physiologique de la veratrine. 
f Bull Gen. de Therap. , CV, 430. Sur Taction physiologique de la veratrine. 
J Arch, fur exper. Pathol, u. Pharmakol., 1887, p. 36. Untersuchungen uber die 
Wirk. der Veratrumalkaloide, von H. Lissauer. \ Ibid. 

|| Journal de P Anatomie et de la Physiologie, 1868, p. 206. 
If The Journal of Physiology, Vol. IV, p. I. 



246 MATERIA MEDIC A AND THERAPEUTICS. 

zoinated lard 96 parts) ; or dissolved in alcohol, as an application to 
the painful spots of rheumatic and neuralgic affections. Oleatum vera- 
trince {ole ate of veratrine) consists of veratrine 2 parts, to 98 parts of 
oleic acid : useful in spinal irritatioji y rubbed over the vertebrae, 

PULSATILLA— PASQUE-FLOWER. 

Description and Constituents. — The herb of Anemone Pulsa- 
tilla and Anemone pratensis (Nat. Ord. Ranunculaceae), is found in both 
hemispheres. It should be collected soon after flowering and care- 
fully preserved, but should not be kept more than a year. It con- 
tains an acrid volatile oily substance, easily converted into anemonin, 
C 15 H 12 6 , and amnionic acid, C 15 H 14 7 (Maisch). 

Incompatibles- — The caustic alkalies, tannic acid, and metallic 
salts. 

Aids. — Aconite enhances its action upon the heart, respiration, 
and temperature. 

Physiological Effects.— Locally, fresh pulsatilla is an irritant, 
due to its oil, and after prolonged contact with the skin causes inflam- 
mation. When the powder is inhaled it produces itching of the eyes, 
colic, vomiting, diarrhcea, etc. (Phillips). Gastro-intestinal tract : the 
taste of the herb is very acrid ; it is an irritant poison, in large doses 
producing vomiting and purging. Nervous system : motor and sen- 
sory paralyses are produced in animals by large doses, but in what 
way has not yet been ascertained. After poisonous doses, dilatation 
of the pupil, sopor, coma and convulsions occur. Circulation: Pulsa- 
tilla is a cardiac depressant, and lowers the arterial pressure. Respira- 
tion and temperature : it slows the respiration (Clarus), and reduces the 
temperature. Elimination : probably takes place through the kidneys. 

Medicinal Uses. — Pulsatilla, owing to its irritant action on the 
digestive tract, is not well borne, and, moreover, possesses no superi- 
ority over more efficient sedatives like aconite. 

Administration. — The powdered herb may be given in doses of 
gr. ij-v, or a tincture may be made ; dose, Tftxv-xlv. 

ARNICA— LEOPARD'S BANE. 
Arnicae Flores, Arnica Flowers ; Arnicae Radix, Arnica Root. 

Description, Habitat and Official Portion. — Arnica montana, 
(Nat. Ord. Compositse), is a perennial herbaceous plant, found in 
northern Germany and other northern countries of Europe, and also 
in the northwestern portions of America. The flower- heads and the 
rhizome and roots are the official portions. 



SEDA TIVES—POKE-R OOT. 247 

« 

Chemical Constituents. — Both contain volatile oil, arnicin * (C 12 
H 22 2 ), resins, etc.; the root contains, in addition, inulin and tannin. 

Physiological Effects. — Locally, arnica is a stimulant and often 
an irritant to the skin. The flowers have a bitter, acrid taste ; the roots 
are pungently aromatic and bitter. The internal effects of this drug 
are not well understood. Small amounts produce a sense of warmth 
in the stomach. In large doses it is an irritant to the gastro-intestinal 
tract, producing nausea, vomiting and purging of a choleraic character, 
and also great muscular weakness. Large quantities cause headache 
and dilatation of the pupils ; poisonous doses paralyze the nervous 
system, and death ensues from collapse. Moderate doses lower (in 
dogs) the pulse by stimulating the pneumogastrics peripherally and 
centrally, raise slightly the arterial pressure, and depress the respira- 
tion and temperature.f Small doses are said to excite the action of 
the skin and kidneys. 

Medicinal Uses. — In this country it is principally used externally, 
in the form of fomentation or lotion, for the relief of bruises, wounds, 
sprains and local paralysis. 

Administration. — The extract of the root (alcoholic) (extractum 
arnicce radicis) is given in doses of gr. v-x. This is chiefly used, how- 
ever, in making a. plaster (emplastrum arnicce). The fluid extract of the 
root (extractum arnicce radicis fluidum) is given in doses of TTLx-xx. 
The tincture of the root [tinctura arnicce radicis), and the tincture of the 
flozvers (tinctura arnicce florum) may be given in doses of ttlv-xxx. 
They are often used externally combined with soap-liniment. In ap- 
plying arnica externally, the irritating qualities of the drug should be 
borne in mind. 

PHYTOLACCA— POKE-ROOT. 

Phytolacca Fructus, Phytolacca Fruit ; Phytolacca Radix, Phytolacca Root. 

Description and Habitat. — Phytolacca is the fruit and root of 
the Phytolacca decandra (Nat. Ord. Phytolaccaceae), commonly known 
as Poke-Berries. It is a perennial herb, indigenous to North America, 
growing to the height of four to eight feet, and found in waste places. 
The young stems, collected in the spring and boiled, are sometimes 
eaten at table. 

Chemical Constituents. — The root contains resin, starch, tannin, 
etc. ; the berries contain sugar, gum, coloring matter, etc. An indif- 

* Pharm. Centralhalle, 1892. Borner. 

| Boston Med. and Surg. Journ., Jan. 12th, 188 , H. A. Hare. 



248 MATERIA MEDICA AND THERAPEUTICS. 

ferent crystalline principle termed phytolaccin has been isolated, by 
Claassen.* Trimble,t in a recent analysis, found a substance resembling 
saponin. 

Physiological Effects. — Its taste is sweet and acrid. Large 
doses produce nausea and vomiting, which do not take place until 
about one hour after the drug is administered, and which are accom- 
panied by great depression. Rutherford found it to be a powerful 
hepatic stimulant, increasing the secretion of the bile. Phytolacca 
paralyzes the motor-centres of the cord and medulla. In overdoses it 
causes dimness of vision, coma and sometimes convulsions (Stille and 
Maisch), and death is produced by paralysis of the respiratory centre. 
Phytolacca depresses the cardiac action and respiration. It is elimi- 
nated by the kidneys. 

Medicinal Uses. — Phytolacca has been used with success as an 
alterative in the treatment of rheumatism of syphilitic origin (Stille and 
Maisch). It is useful in phlegmons % of the breast, to allay the inflam- 
mation and prevent suppuration, and possibly may exert a like influence 
on other inflamed glands, as adenitis. As it produces great depression 
it should not be used as an emetic. 

It is recommended as a topical application to leg ulcers (Tidd §) 
and eczema , and also in scabies and tinea capitis. || 

Administration. — Dose of the powder, gr. j-xxx ; or a tincture 
(5j'v-0j), or fluid extract (extraction phytolaccce fluiduni) may be used, 
dose, Tftv-f5j. For topical use, an ointment may be prepared (5~oj). 

staphisagria— stavesacre, or licebane. 

Description and Habitat. — Staphisagria is the seed of the Del- 
phinium Staphisagria (Nat. Ord. Ranunculaceae), a beautiful biennial 
plant, with terminal racemes of blue flowers, native of southern Europe. 

Chemical Constituents. — It contains three alkaloids, delphinine 
(C^H^NC^q), delphinoidine, delphisine, and staphisain (QgH^NC^) ; also 
fixed oil, etc. 

Physiological Effects. — When applied to the skin delphifiine 
acts as a rubefacient and irritant, and parasiticide. The taste of the 
seed is bitter and acrid. It provokes salivation and induces vomiting 

* The Pharmacist and Chemist, 1879, p. 466. 

I Am. Journ. of Pharmacy, June, 1893. 

\Amer. Journ. Med. Sci., 1873, P- 2 75- 

I The Clinic, Vol. v, p. 273. 

|| J. Bigelow, quoted in Piffard's " Mat. Med. and Therap. of the Skin." 



SEDA TIVES— ANTIMONY. 249 

(an early symptom), due to irritation of the end-organs of the pneu- 
mogastric nerves. It acts upon the digestive system no matter how 
introduced. When administered internally to animals in lethal amounts 
it produces convulsions, muscular inco-ordination, and finally clonic 
spasm ; the reflex centres of the cord are palsied (Cayrade),* and 
cutaneous anaesthesia is produced (Falck and Rorig f ), and finally the 
respiratory centre is paralyzed, causing death from asphyxia. The 
effects on the circulation are most marked. It slows the cardiac action 
and paralyzes the heart by a direct action on its muscle and nervous 
supply (Flack and Rorig, j L. Van Praag). It causes dyspnoea, slows 
the respiratory movements and paralyzes the voluntary muscles. It is 
eliminated chiefly by the biliary and salivary secretions and kidneys, 
producing constipation and difficult urination during excretion. 

Toxicology and Antidotes. — It destroys life by ashyxia. The 
treatment of poisoning by staphisagria should be by artificial respira- 
tion, strychnia and atropia. 

Medicinal Uses. — It is chiefly used as a local parasiticide against 
pedicnli and scabies , although an ointment is applied in phthiriasis. 

Administration. — Dose of the powder, gr. j-iij ; or a tincture (i 
part to alcohol 5 parts — dose TVLx-xv), or fluid extract may be used. 
An ointment (digest 5ij of bruised seed in lard gj and strain while 
hot) is the best form for external use. None of these preparations 
are official. 

ANTIMONII PR.EPARATA— PREPARATIONS OF ANTIMONY. 

Antimonii Oxidum (Antimonious Oxide) (Sb 2 3 ) is a heavy gray- 
ish-white, insoluble powder, having the general therapeutic properties 
of the antimonials, and though not quite certain in its effects — as its 
solubility depends on the amount of hydrochloric acid which may 
exist in the stomach — it is believed to produce the sedative operation 
of tartar emetic, with less nausea and derangement of the stomach. 
Dose, gr. ij-iij ? repeated. 

Antimonii et Potassii Tartras (Antimoninm and Potassium Tar- 
trate), (2 K(SbO)QH 4 6 + H 20). 

Preparation, Properties and Test. — This salt, familiarly known 
as tartar emetic, is prepared by boiling water and^cream of tartar with 

* Journ. de VAnat. et de Physiol. Mai et Juin, 1869. 317. 

f Archiv. filr. phys., Heilkun., 525-548, 1 85 2, and Rorig 's Dissert, de Effectu Del- 
phini, Marburg, 1852. 

% Virch. Arch., Bd. VI., 385-448, und 435-457. See also researches on Staphisagria 
in Bull. Gen. de Therap., 1 891, by Gautier, p. 185. 



250 MATERIA MEDICA AND THERAPEUTICS. 

antimonious oxide. It occurs in colorless, transparent, rhombic, 
octahedral crystals, which become white and opaque from efflorescence 
on exposure to the air. When pure its powder is perfectly white ; 
but it is to be preferred in the crystalline state, as in this form it is less 
liable to adulteration. Tartar emetic is inodorous; is soluble in 15 
parts of cold and 3 parts of boiling water ; insoluble in pure alcohol. 
In testing for antimony the metal itself should be reduced, as by Marsh's 
test (see Arsenious Acid). The powder of tartar emetic is sometimes 
adulterated with cream of tartar, which may be detected by adding a 
few drops of a solution of sodium carbonate to a boiling solution of 
the antimonium salt, and if the precipitate formed be not re-dissolved, 
no potassium bitartrate is present. 

Incompatibles of Tartar Emetic. — It is decomposed by the 
alkalies and the alkaline carbonates ; the vegetable astringents con- 
taining tannic acid form an insoluble tannate with it. 

Aids. — Aconite, veratrum viride*, etc., enhance its sedative 
powers ; ipecacuanha promotes its emetic effect ; paregoric, sweet 
spirit of nitre and ipecacuanha (small doses), its diaphoretic action. 

Physiological Effects. — Tartar emetic is a powerful local irri- 
tant. Applied to the skin, it occasions an eruption of pustules, 
resembling those of variola or ecthyma. Its taste is at first sweetish, 
then metallic. When taken into the stomach, in full doses, it causes 
vomiting, purging, griping pains, etc. The constitutional effects of 
tartar emetic, when taken internally in small doses, are an increase in 
the secretions and exhalations generally, especially from the skin ; 
the quantity of carbonic acid exhaled by the lungs is increased ; the 
amount of urine excreted is lessened, but the urea is much augmented 
(Ott) ; after large doses albuminuria is often seen ; in somewhat 
larger doses, these effects are accompanied with nausea and vomiting, 
relaxation of the tissues (particularly the muscular fibres), a feeling of 
great feebleness and exhaustion, and at first a stimulant, later a power- 
ful sedative, action on the circulation and respiration, the cardiac action 
becoming slow, weak and finally irregular, and the arterial tension 
lowered. Majendie's experiments indicate that it provokes emesis by 
acting on the vomiting centre. It acts on the heart by depressing the 
excito-motor nerves and paralyzing the cardiac muscle. After poison- 
ous doses the red blood-corpuscles are altered in form, and together 
with the albumen, are diminished in amount in the blood of animals; 
the fibrin is increased (Ott). The temperature of the body is lowered. 
In small, repeated doses, continued for some time, it produces fatty 



SEDATIVES— ANTIMONY. 251 

degeneration of the liver. It is eliminated slowly by the bile, milk, 
perspiration and urine, also by the bronchial mucus and the intestinal 
secretions. 

Toxicology. — In excessive quantity, it acts as an irritant poison, 
and has produced death with great prostration, syncope, and diminu- 
tion of reflex irritability. The minimum fatal dose for an adult is 
gr. ij ; for a child, gr. ^ (Taylor). On the other hand, very large 
quantities have been taken without fatal results. 

Antidotes. — Fortunately the ingestion of toxic amounts of tartar 
emetic is quickly followed by vomiting. But if the poison has not 
been entirely rejected, or if emesis has not occurred at all, tannic acid, 
the chemical antidote, should be administered (strong infusion of tea, 
cinchona or oak-bark), which forms an insoluble tannate, and con- 
sequently the absorption and irritative action of the poison is 
impeded. After this the stomach-pump must be used. Should 
there be evidence of much gastric irritation, the exhibition of demul- 
cents will be in order. 

Medicinal Uses. — Tartar emetic is employed internally as an 
emetic, sedative, sudorific and expectorant, and topically as a counter- 
irritant. It is to be used with great caution on account of the pros- 
tration which it produces, and should never be given to young chil- 
dren, nor when gastro-enteric inflammation is present. It should only 
be used in sthenic cases in robust adults. As an emetic, it creates 
more nausea and depression than any other substance ; and hence, 
while other emetics are to be preferred to it, when our object is merely 
to evacuate the contents of the stomach with as little constitutional 
disturbance as possible, it is of value when vomiting is to be resorted 
to as a means of making an impression on the system, in the hope 
of checking the progress of disease. As a sedative antiphlogistic ■, in 
large doses it is a most powerful remedy in the treatment of acute 
inflammation, with fever, from its combined action in reducing the force 
and frequency of the circulation, moderating the heat of the skin, and 
promoting diaphoresis. When given in this way, at intervals, tartar 
emetic ceases to produce emesis, owing to the establishment of toler- 
ance of the medicine. It is inferior to other sedatives, as aconite, etc. 
In the early stages of acute laryngitis and bronchitis, it is a remedy of 
great value. From gr. t&-}{ may be given every two hours in gradu- 
ally increasing doses, until some amelioration of the symptoms takes 
place, when the doses are to be again decreased; a favorite combina- 
tion with many physicians is : 1^ Antimonii et potassii tartratis, mor- 



252 MATERIA MEDICA AND THERAPEUTICS. 

phinae sulphatis, aa gr. j ; aquae, fsij. M. One teaspoonful contains 
gr. T ^ each of tartar emetic and morphine. As a diaphoretic, it is very 
useful in small doses (as from -h-%, repeated), in continued fevers, 
inflammation from wounds, injuries, etc.; and as an expectorant, when 
there is fever, a full pulse, and but little expectoration, as in acute 
bronchitis, in the same doses ; it is also employed in various pulmonary 
affections with advantage. As a topical irritant, it is rarely used, and 
is in many cases injurious. 

Administration. — The dose of tartar emetic, as an emetic, is 
gr. j-ij, and it is combined with ipecac. As a sedative antiphlogistic, 
gr- %—yi to gr. j-ij, in powder with sugar of milk. As a diaphoretic 
and expectoraiit, gr. ts-%> may be given in solution, and in each case 
repeated every two or three hours. Tartar emetic is seldom pre- 
scribed nowadays. 

Vinum Antimonii (Antimonial Wine) is a solution of tartar emetic 
(4 parts) in boiling distilled water (65 parts), alcohol (150 parts), and 
stronger white wine (to make 1000 parts). It is employed as an expec- 
torant and sudorific in bronchitis, etc., in the dose of from gtt. x-xxx, 
frequently repeated ; and as an emetic for children, in the dose of gtt. 
xxx to f5j, repeated every quarter of an hour. Other emetics are to 
be preferred. 

Antimonii Suiphidum (Antimonious Sulphide) (Sb 2 S 3 ), the native 
sulphide, purified by fusion, and Antimonii Sidphidum Purificatum 
(Purified Antimonious Sidphide), are used in making the other 
preparations. 

Antimonium Sulphuratum (Sulphurated Antimony) is a reddish- 
brown, odorless, almost tasteless, insoluble powder, and is chemically 
a mixture of antimonious sulphide (Sb 2 S 3 ) and oxide (Sb 2 O s ). Its 
effects are analogous to those of tartar emetic. Dose, gr. j-iij ; as an 
emetic, gr. v-xx. 

Pilulee Antimonii Compositae {Compound Pills of Antimony), some- 
times called Plummets Pills. They are used as an alterative in 
rheumatic and cutaneous affections, and contain calomel, sulphurated 
antimony, and guaiac ; dose, 1-3. 

Pulvis Antimonialis (Antimonial Powder). — This is prepared in 
imitation of the celebrated James's Powder, by mixing antimonious 
oxide (33 parts) with precipitated calcium phosphate (67 parts). It is 
a white, gritty, tasteless, odorless powder. Dose, gr. iij-viij ; seldom 
used. 



SEDATIVES— POTASSIUM NITRATE. 253 

POTASSII NITRAS -POTASSIUM NITRATE. 

Preparation. — This salt, commonly called nitre and saltpetre 
(KN0 3 ), occurs in both the inorganic and organic kingdoms of nature. 
It is obtained, for medicinal use, principally by the purification of the 
native nitre of India ; and it is found also in saltpetre caves in various 
parts of the United States, associated with calcium nitrate, from which 
it is separated by lixiviation. Nitre is refined by re-solution and 
crystallization of the crude nitre. 

Properties. — As purified for medicinal use, it is found in the 
shops in large, transparent, colorless crystals, of the form of six-sided 
striated prisms, with dihedral summits, which are unalterable in the 
air. They have no odor, a sharp taste, are wholly soluble in water, 
and insoluble in pure alcohol. They are without water of crystalliza- 
tion, but frequently have a portion of the mother liquid mechanically 
lodged in the spaces of the crystals, which may be driven off by 
heat, and the salt fused and cast into moulds, when it is termed sal 
prunelle. 

Physiological Effects of the Potassium Preparations. — 
As the effects of the potassium salts are largely due to their base, 
it will be more convenient to consider them together, pointing out 
any differences when the various preparations are considered. 
Locally, some of this group, as potassa fusa, abstract water from 
the tissues, dissolve albumen, saponify fats, and hence are caustics. 
The nitrate is a violent irritant when applied to mucous membranes 
or raw surfaces. It has a sharp, cooling, pungent taste. Gastro- 
intestinal tract : when the alkalies are given on an empty stomach, 
the secretion of the acid gastric juice is increased ; if given when 
gastric digestion is in progress, they neutralize the acidity of the 
secretion. In large amounts, potassa or the chlorate, nitrate, carbonate 
or chloride [excites violent inflammation, causing vomiting, purging, 
etc. Nutrition : the alkalies in small doses improve digestion, aid in 
saponifying fats, and promote oxidation of tissue ; but when admin- 
istered for too long a time, especially if given in large doses, they 
cause emaciation and pervert nutrition. Secretion : the alkaline 
potassium compounds, like alkalies in general, when applied to the 
orifices of glands with acid secretions, increase, but when applied to 
glands with alkaline secretions, diminish their secreting power (Ringer). 
This does not apply to the nitrate. They increase the water of the 
urine and the urea, and lessen the amount of uric acid. If the bi- 



254 MATERIA MEDICA AND THERAPEUTICS. 

carbonate is given during fasting, the acidity of the urine will be 
increased, but the urine will be alkaline if it is administered during 
digestion. The alkalinity of the urine is most marked after the inges- 
tion of the salts with the vegetable acids (as the tartrate, citrate, etc.). 
The nitrate and chlorate do not affect the reaction of the urine. 
Nervous system : in large doses, they may produce coma, and they 
act on the spinal centres, by lowering reflex excitability and causing 
paralysis of the lower extremities when given in large amounts. 
Circulation : all the potassium salts are cardiac poisons, their activity 
being due to the potassium, and varying with the amount of the base 
they contain. In moderate doses they slow the heart and increase 
the arterial pressure, while in large doses they both diminish the 
frequency of the cardiac pulsations and lower the blood-pressure. 
Animals poisoned by them die from cardiac paralysis (the heart being 
arrested in diastole), caused by direct action on the cardiac muscle 
and also by paralysis of the cardiac ganglia. Blood : after large doses, 
or when taken for some time, the blood is found to be less coagulable 
(the fibrin being diminished), the white corpuscles relatively increased, 
and the venous blood lighter in color (Phillips). After large doses of 
the nitrate or chlorate, the blood becomes dark and refuses to take up 
oxygen, and the haemoglobin is decomposed. The compounds with 
the vegetable acids increase the alkalinity of the blood. Temperature 
is reduced by large doses, especially when the nitrate or chlorate has 
been given. Elimination : the potassium salts are eliminated chiefly 
by the urine, but to some extent also by the other secretions. The 
salts with the vegetable acids, during their passage through the 
system, are converted into carbonates and are eliminated under this 
form. Potassium nitrate and chlorate are discharged unchanged in 
the urine and as sulphates in the faeces. 

Toxicology. — In excessive doses, nitre may act as a fatal poison, 
producing irritation of the alimentary canal and derangement of the 
nervous system ; the symptoms are burning pain in the throat and 
stomach, bloody stools, a tendency to syncope, collapse, and death, 
sometimes preceded by dilated pupils, insensibility and convulsions. 
Fatal results * have been caused by §i-ij in a few hours. There is no 
antidote for it, and cases of poisoning are to be treated by demulcents, 
opiates, stimulants, etc., after evacuation of the contents of the 
stomach. 

* Medical Jurisprudence, etc. Reese, 18S9. 



SEDATIVES— POTASSIUM CITRATE. 255 

Medicinal Uses. — Nitre is not as much used as it was formerly. 
It may be given as a refrigerant and sedative in fevers and inflammations. 
In fevers it is sometimes prescribed with calomel and tartar emetic, 
under the name of nitrous powders (nitre, gr. x ; tartar emetic, gr. yi ; 
calomel, gr. y^ to ^). It is sometimes combined with Dover's powder 
(of each, gr. iij-v or viij) in the treatment of acute muscular rheu- 
matism. 

Administration. — Dose, gr. x-xxx. From 5iv-yj are given in 
twenty-four hours, in acute rheumatism, and the quantity is increased 
to 5viij-x 7 or xij. Charta Potassii Nitratis {Potassium Nitrate Papa') 
consists of strips of white unsized paper immersed in solution of potas- 
sium nitrate (20 parts to 80 parts of distilled water). The inhalation 
of the fumes arising from the burning of these papers is used with 
advantage in spasmodic asthma. 

Sodii Nitras [Sodium Nitrate, NaN0 3 ). — This salt, commonly 
called cubic nitre, is found in large deposits in South America, chiefly 
in Peru, but also in Bolivia and Chili. The crude salt occurs in rather 
soft and pliable lumps, of white, yellow or gray color. It occurs in 
colorless rhombohedral crystals, slightly deliquescent, and wholly 
soluble in water, without odor, and of a sharp, cooling and bitter 
taste. 

Effects and Uses. — Sodium nitrate has been little used in med- 
icine. Its effects and dose are analogous to those of potassium nitre. 
The sodium salts are not as powerful cardiac poisons, neither do they 
affect the temperature nor act on the nervous system to the same ex- 
tent. They impede coagulation, but do not alter the blood-corpuscles. 

REFRIGERANTS. 
POTASSII CITRAS— POTASSIUM CITRATE. 

Preparation and Properties. — This salt (K 3 C 6 H 5 7 + H 2 0) 
(formerly known as Salt of Riverius) is made by saturating a solution 
of citric acid with potassium bicarbonate, and evaporating to dryness. 
It is white, granular, inodorous, of a saline, slightly bitterish, but not 
unpleasant taste, deliquescent, and wholly soluble in water. 

Effects and Uses. — The salts of the alkalies with vegetable 
acids, as citrates, tartrates and acetates, during their passage through 
the body are converted into carbonates. To neutralize the urine in 
renal calcidi, due to uric acid, 5/^-j should be taken every three hours 
for two or three months. It is an excellent refrigerant diaphoretic, 
much employed in febrile affections. 



256 MATERIA MEDIC A AND THERAPEUTICS. 

Administration. — Dose, gr. xx-xxv ; 5yj are usually dissolved 
in water Oss, and f5ss of the solution is administered every hour or 
two. 

Liquor Potassii Citratis (Sohitio?i of Potassium Citrate) (con- 
tains 9 per cent, of potassium citrate), may be made by dissolving 
separately citric acid 6 parts and potassium bicarbonate 8 parts in 
water enough to make the combined solution weigh ioo parts; 
dose, f§ss. 

Effervescent Potassium Citrate [Potassii Citras Effervescens) has 
been added to the U. S. P. of 1890, anfi consists of citric acid 63 
parts, potassium bicarbonate 90 parts, and sugar 47 parts, powdered 
separately and mixed in a warm mortar. It is an excellent remedy for 
gastric irritability with fever ; dose, 5iss in a tumbler of water. 

LIQUOR AMMONII ACETATIS— SOLUTION OF AMMONIUM ACETATE. 

Preparation and Properties. — This solution, termed also 
Spiritus Minder eri y or Spirit of Minder erus y is made by saturating 
diluted acetic acid with ammonium carbonate, and is a solution of 
ammonium acetate (NH 4 C 2 H 3 2 ). When pure it is a colorless liquid, 
with a saline taste ; it should always be made freshly when dispensed. 
The physiological effects of the ammonium salts have already been 
considered (vide index). 

Effects and Uses. — In small doses it is refrigerant ; in larger 
doses, diaphoretic and diuretic. It is employed in febrile^ and inflam- 
matory affections, sometimes in conjunction with nitre or one of the 
sedatives, sometimes combined with camphor and opium. Given in 
full doses, frequently repeated, it is one of the best means of removing 
the effects of alcoholism. 

Administration.— Dose, foss-j every two, three or four hours, in 
sweetened water. 

SPIRITUS iETHERIS NITROSI— SPIRIT OF NITROUS ETHER. 

Composition and Properties. — This preparation, commonly 
known as Sweet Spirit of Nitre, is a solution of ethyl nitrite (4 per 
cent.) (C 2 H 5 N0 2 ) in alcohol. Spirit of nitrous ether is a volatile, 
inflammable liquid, of a pale-yellow color, inclining slightly to green, 
has a fragrant, ethereal odor, free from pungency, and a sharp, burning 
taste, and mixes with water and alcohol in all proportions ; sp. gr. 
0.823 to 0.825. It should not be long kept, as it becomes strongly 
acid by age. 



SEDATIVES— VEGETABLE ACIDS. 257 

Incompatibles. — Mucilage of acacia, antipyrine, and it liberates 
iodine in solutions of the iodides. 

Effects and Uses. — Sweet spirit of nitre is antispasmodic, refrig- 
erant, diaphoretic, and diuretic. As a diaphoretic, small doses should 
be given largely diluted and frequently repeated. It is much used in 
febrile affections, and, from its diuretic properties, is often combined 
with other diuretics in the treatment of dropsies. From its pleasant 
taste and smell it is very acceptable to children. 

Toxicology. — The inhalation of sweet spirit of nitre has pro- 
duced dangerous and even fatal effects : pallor of the face, livid dis- 
coloration of the lips and fingers, weakness of the pulse, muscular 
prostration, precordial oppression, and headache are the symptoms 
described. The same symptoms maybe produced by excessive doses. 
A case is recorded in which death was attributed to the inhalation of 
the ether from a broken bottle in a sleeping apartment. 

Administration. — Dose, f5ss-j, in water, frequently repeated. 

ACIDA VEGETABILI A— VEGETABLE ACIDS. 

The vegetable acids are refrigerant, and, when properly diluted, 
form useful drinks in fevers, etc. Those chiefly employed are acidnm 
aceticum {acetic acid), acidum citricum {citric acid), and acidum tartari- 
cum {tartaric acid). 

Incompatibles. — The alkaline hydrates, carbonates, and acid 
carbonates. The vegetable acids unite to form salts with the alkaline, 
earthy and metallic bases ; the acetates of these are all soluble. Acetic 
acid forms red ferric acetate with tincture of ferric chloride. 

Toxicology. — There are no recorded cases of poisoning with 
citric acid; tartaric 5^ is alleged to have caused death in one instance; 
fatal results from acetic are rare.* The antidotes are the alkalies. 

Effects and Uses. — The following description is based on the 
investigations of H. Bench Jones f and F. Walter.^ Applied to a raw 
surface or (if sufficiently concentrated) to the mucous membranes, 
they act as irritants. Acetic acid is the most powerful, and will, when 
applied to the skin, cause blanching, from contraction of the capil- 
laries. Citric acid is the least irritant. Their taste is intensely acid, 
and within the mouth they augment the flow of saliva, and relieve 
thirst. The general law regarding the action of acids on secretion 

* Medical Press and Circular, Nov. 17th, 1880, p. 417. 
f Medical Times and Gazette, Oct. 2 1st, 1854. 
% Arch, fur exper. Pathol, u. Pharm., 1877, p. 148. 
17 



258 MATERIA MEDIC A AND THERAPEUTICS. 

holds good here : viz., when applied to glands secreting an acid fluid 
they diminish, and when applied to glands giving off an alkaline fluid 
they augment their secreting power, — hence the increased flow of 
saliva noted after they enter the mouth. In medicinal amounts they 
make no obvious impression in the stomach. According to Walter, they 
do not neutralize the alkalinity of the blood, and it is unknown how they 
exist in this fluid. The flow of the alkaline intestinal secretion is in- 
creased by the vegetable acids. Their continued use causes abdominal 
pain, flatulence and diarrhoea. In large doses they produce gastro- 
enteritis, and if continued for a lengthy period they induce scorbutic 
symptoms. After large doses the cardiac beat is slowed and weakened ; 
but this is possibly due to the resulting gastro-enteritis. The ingestion of 
the vegetable acids increase the acidity of the urine. They also promote 
the excretion of both the water and the solids of the urine, particu- 
larly free uric acid, and may thus lead to calculus. They are probably 
converted into carbonic acid in the system, unite in part with bases to 
form salts, and are eliminated by the kidneys and intestinal mucous 
membrane. 

Acidum Aceticum [acetic acid, 36 per cent, by weight of absolute 
acid in water,) (HC 2 H 3 2 ) is employed internally only in the form of 
diluted acetic acid (acidum aceticum dilutum), dose, f5j-ij. It contains 
6 per cent, of absolute acid in water. Acetic acid is prepared by 
adding sulphuric acid to sodium acetate and condensing the given 
off vapor in water. Topically, acetic acid (sp. gr. 1.048), and glacial 
acetic acid [acidum aceticiun glaciale), crystalline, absolute acetic acid, 
(sp. gr. 1.058) are employed as escharotics to remove warts and in the 
cure of lupus. The diluted acid is employed to remove the scales of 
psoriasis, and to destroy the nits in pedicidosis. Vinegar is a popular 
household remedy in epistaxis, and is introduced within the nostrils on 
cotton tampons. Acetic acid is less used internally as a refrigerant 
than citric acid, from its liability to produce colic and diarrhoea. 
Vinegar and water is one of the best injections for the cure of gonor- 
rhoea in the female. Spongings with vinegar and water are useful to 
relieve the heat of the skin in fevers, to check sweating, as a wash in 
urticaria, and the vapor is grateful to the sick. Concentrated acetic 
acid is a corrosive poison, for which the alkalies and their carbonates, 
soap, etc., are the antidotes. 

Acidum Citricum {citric acid) (H 3 C 6 H 5 7 ) may be agreeably 
administered in the diluted juice of lemons, limes, sour oranges, and 
tamarinds. When these cannot be obtained, a solution of citric acid 



SPINANTS. 250 

(gr. xx to water Oj) may be substituted. Citric acid is manufactured 
from lemon or lime-juice, by saturating it with calcium carbonate and 
afterward decomposing the calcium citrate which is formed, by the addi- 
tion of sulphuric acid. It occurs in colorless crystals, having the form of 
rhomboidal prisms with dihedral summits, freely soluble in water, and 
soluble in alcohol ; 5ixss, added to distilled water Oj, form a solution 
of the average strength of lemon-juice. In the dose f5j every hour 
or two, lemon-juice (limonis succus) (the fresh juice of the fruit of Citrus 
Limonum), {Nat. Ord. Rutaceae) has been employed as an antacid. 
Properly diluted and mixed with sugar, it forms the delightful refrig- 
erant known as lemonade. In the early stage of actite ?iasal catarrh, 
or " cold," with hot, dry skin and fever, a hot lemonade taken at night 
in bed will do much toward counteracting the febrile symptoms. 
Lemon-juice (or, still better, lime-juice) is the most efficient known 
remedy for scurvy, and it is almost infallible as a prophylactic against 
this malady. Syrup of citric acid (syrupus acidi citrici) consists of 
citric acid (10 parts) and water (io parts) with spirit of lemon (10 
parts) and syrup (970 parts). Spirit of lemon (spiritus limonis) (some- 
times called essence of lemon) is made by dissolving oil of lemon (oleum 
limonis} 5 parts (obtained from the rind of the recent fruit [limonis cor- 
tex), in alcohol 90 parts, and adding freshly grated lemon-peel 5 parts; 
dose, f5j-ij- 

Acidum Tartaricum, [Tartaric Acid}, (H 2 C 4 H 4 6 ) is the acid of 
grapes, and is extracted from tartar or crude cream of tartar. It is 
a white crystallized solid, in the form of irregular six-sided prisms, and 
is found in the shops as a fine white powder, soluble in water and 
alcohol. Being cheaper than citric acid, it may be used as a 
substitute for that acid. It is employed in making Seidlitz powders. 
Tartaric acid in excess yields a precipitate (cream of tartar) with 
a solution of carbonate or other neutral salt of potassium, while 
citric acid yields none. 

ORDER VIII. SPINANTS. 

Under the term Spinants, or Spastics, are comprised medicines 
which are employed to excite muscular contraction, or whose ultimate 
effect is the production of motor-paralysis, and may, accordingly, be 
divided into excito-motors and depresso-motors. Of the frst class, 
the most important articles are vegetable substances containing the 
alkaloids strychnine and brucine, which are employed therapeutically 
in torpid or paralytic conditions of the muscular system ; ergot, 



260 MATERIA MEDIC A AND THERAPEUTICS. 

which is used to excite muscular contraction of the uterus ; and 
digitalis, which is given for its tonic effect on the heart. Paramor- 
phine is also an excito-motor agent (see p. 84). The second class con- 
tains such remedies as conium, physostigma, woorara, etc. 

EXCITO-MOTORS. 
NUX VOMICA. 

Description, Habitat and Official Portion. — Strychnos Nux 
vomica, or Poison-Nut [Nat. Ord. -Loganiaceae), is a middling-sized 
tree of the coast of Coromandel and other parts of India, which bears 
a round, smooth berry, the size of a pretty large apple, of a rich 
orange color, and containing numerous seed imbedded in a juicy pulp. 
The seed are the official portion ; but the bark also is poisonous, and 
is known as false angustura bark, from its having been confounded 
with angustura bark. 

Properties. — The seed are round, peltate, less than an inch in 
diameter, nearly flat, or convex on one side and concave on the other, 
and surrounded by a narrow annular stria. They have two coats ; a 
simple fibrous outer coat, covered with short, silky hairs, of a gray or 
yellowish color, and a very thin inner coat which envelops the nucleus 
or kernel. This is hard, horny, of a whitish or yellowish color, and 
of very difficult pulverization. The seed have no odor, but an intensely 
bitter taste, which is stronger in the kernel than in the investing 
membrane. 

Chemical Constituents and Tests. — They impart their virtues 
to water, but more readily to diluted alcohol, and contain two active 
alkaloids, strychnine (official) and brncine, both of which exist in com- 
bination with an acid called igasuric; another alkaloid, termed tgasurine 7 
much more soluble in water than the two first named, has been lately 
extracted from nux vomica ; also loganin. 

Strychnina (Strychnine) (C 21 H 22 N 2 2 ) is obtained from the seeds, 
and after extraction is converted into a sulphate by the addition of 
diluted sulphuric acid; it occurs as a white or grayish-white powder 
(but may be made to crystallize in the form of white, brilliant rhombic 
prisms), of an intensely bitter taste, almost insoluble in water, slightly 
soluble in cold alcohol, but readily soluble in boiling alcohol. A very 
delicate test for strychnine is the potassium bichromate : this, added to 
a solution of strychnine in concentrated sulphuric acid, produces a 
violet color, which after a time changes to wine-red, and then to red- 
dish-yellow. Lead binoxide, manganese peroxide, potassium ferrocy- 



SPINA NTS— NUX VOMICA. 261 

anide and permanganate act in the same way. In these tests the 

reagent is nascent oxygen. The presence of morphine in excess, of 

certain undefined organic substances,* and of curare, may disguise the 

color-test ; here an alkaline mixture of chloroform should be used to 

separate the strychnine from morphine ; while curare can be distinguished 

by its amorphous state. The physiological test should be always 

resorted to ; if a small frog be placed in an ounce of water containing 

tito of a grain of a strychnine salt, in two or three hours it will 

undergo tetanic spasms, and soon die. 

Brucine (C 23 H 26 N 2 4 , not official) resembles strychnine in its 

action (Maysf). It differs from it in being locally analgesic and often 

destroying life without a trace of spasm. In the case of an adult % 

gr. ij induced convulsions which were counteracted by chloral. The 

dose is gr. ¥ V-rV- 

Fig. 21. 




STRYCHNOS NUX VOMICA. A, B, SEEDS. 

Incompatibles. — Tannic acid, the iodides, chlorides and bromides 
yield precipitates with strychnia ; the strychnia bromide forms only 
after standing and can be prevented by dilute HC1. 

Aids. — Electricity, picrotoxin, ergot, ustilago, and ignatia. 

Physiological Effects. — Locally strychnia possesses the power 
to a slight degree of arresting the movements of protoplasmic life, and 
it can be absorbed from mucous surfaces. Both nux vomica and 
strychnia have an intensely bitter taste. In very small and repeated 
doses they exert a tonic effect due to an increased flow of the 
gastric juice and free acid; at the same time they favor absorption and 
the muscular movements of the stomach. In somewhat larger doses, 
the stomach is often disturbed, the cardiac action is accelerated from 

*" Micro-Chemistry of Poisons," 1885, p. 569. 

I Pamphlet, "The Differential Action of Brucine and of Strychnine," Phila., March, 
1887. 

X Med. and Surg. Reporter, 1882, 194. 



'262 MATERIA MEDICA AAD THERAPEUTICS. 

stimulation of the cardiac ganglia, the visual sense is rendered more 
acute and the retina becomes hyperaemic, and in still larger doses, the 
muscular system becomes disordered. A sense of weight and weak- 
ness in the limbs, and increased sensibility to external impressions of 
all kinds, manifest themselves, with depression of spirits and anxiety ; 
the limbs tremble, and slight convulsive movements of the muscles 
appear. If the medicine be continued, or if a toxic dose be taken, con- 
vulsive paroxysms of the whole muscular system ensue, with erotic 
desires, painful sensations in the skin, and occasionally eruptions ; the 
heart is slowed, and the blood-pressure increased, probably through 
vaso-motor spasm. Nux vomica or its alkaloid, strychnine, increases 
the reflex excitability of the spinal cord, and thus favors the produc- 
tion of convulsions. Its action seems to be especially directed to 
excitation of the spinal motor-centres. Klapp * affirms that even 
lethal quantities in the frog have no action on the sensory or motor 
nerve-endings, nor upon their trunks. This statement, however, is 
denied by Vulpian f and others. After death, galvanization of the 
motor-trunks, causes little or no contraction in response, due to 
direct action on, and exhaustion of the motor trunks. It stimulates 
the vaso-motor centres of the brain and spinal cord (Ott), and 
also the respiratory centre. Large doses paralyze these centres 
at once (Klapp), but the vagi are not affected either in warm- 
or cold-blooded animals. Death is due to asphyxia. In paralytic 
patients the toxic effects of the medicine are principally observed 
in the paralyzed parts. When taken in excessive doses the symp- 
toms usually come on suddenly, and within half an hour, and 
consist of paroxysms commencing with a sudden shuddering, 
quickly passing into a tetanic convulsion of all the voluntary 
muscles. The body is bent backward, until the occiput and heels 
support its weight (opisthotonus), the corners of the mouth are drawn 
up in a ghastly grin (risus sardonicus), and the face, at first pale, 
becomes livid as the paroxysm continues, from interference with res- 
piration. Trismus (an early symptom in tetanus) occurs finally in 
severe cases. After a variable time the muscles relax and an interval 
of quiet succeeds, during which there is sometimes a slight rigidity of 
the muscles, but no marked stiffness as in tetanus. As a rule the 

* The Journ. of Ment. and Nerv. Dis., Oct, 187S, p. 619. "Physiological Action 
of Strychnine on the Brain, Spinal Cord and Nerves." 

f Arch, de Physiologie Norm, et Path., Ill, 1870, 1 16. " Remarques touchant Taction 
de la strychnine sur les grenouilles." 



SPINANTS—NUX VOMICA. 263 

paroxysms are painful. Elimination : Strychnine is said to be elim- 
inated by the kidneys unaltered. 

Toxicology. — If the dose has been sufficient to cause death, the 
paroxysms rapidly succeed one another, increasing progressively in 
severity and duration until dissolution occurs from fixation of the muscles 
of respiration, the intellect being usually unaffected up to the fatal 
termination. The convulsions resulting from the use of strychnine are 
of spinal origin, and are due to an exaltation of the reflex functions 
together with a stimulation of the motor-cells of the cord. The reflex 
centres are in such an irritable condition that the slightest irritation of 
the surface, as by a breath of air, will produce a convulsion. The poison- 
ous dose of strychnia varies widely, as a case * is reported (that of Dr. 
Warner) in which gr. y 2 killed an adult in twenty minutes, while re- 
covery followed in a soldier f who had taken about gr. xv. 

Antidotes. — There is no chemical antidote, unless, perhaps, it be 
tannic acid, which forms an insoluble strychnine tannate. The patient 
is to be kept perfectly quiet, and all sources of irritation, as draughts 
or loud noises, should be excluded as likely to cause a tetanic paroxysm. 
The stomach should be emptied and the physiological antidote, chloral \ 
given. It % acts chiefly by lowering the activity of the parts which 
conduct the excitation to the spinal cord, preventing the too frequent 
repetition of the tetanic spasms and lessening their intensity. In grave 
cases artificial respiration should also be resorted to. Some relief is 
afforded by holding the limbs or even by applying friction to them, 
during the paroxysm. The antidotism between strychnine and chloral 
is not reciprocal. Opium, conium, ether, chloroform, Calabar bean or 
potassium bromide, may also be exhibited as physiological antidotes. 
Recently Prof. Anrep § has called attention to urethan as a physiologi- 
cal antidote to strychnine and other tetanizers. 

Medicinal Uses. — This medicine is our chief resource in torpid 
or paralytic conditions of the motor or sensitive nerves, or of the 
muscular fibre. When, however, paralysis is the result of inflamma- 
tion of the nervous centres, it is injurious, and accelerates organic 
changes. It is most beneficial in those forms of paralysis which are 
independent of structural lesion, as lead palsy or alcoholic paralysis. 
In paralysis arising from apoplexy, as hemiplegia — after the absorption 

* Guy's Hosp. Reports, XI, p. 296. 

^Medico-Legal Journal, Parker, 1885, p. 375. 

% Schmidts Jahrb., June, 1881, quoted by Am. J. M. Set., April, 1882. 

I Bull. Gen. de Therap., Feb. 15th, 1887. Quoted. 



264 MATERIA MEDIC A AND THERAPEUTICS. 

of the effused blood, when the paralysis remains, as it were, from habit 
— the cautious employment of nux vomica is often attended with 
advantage. In amaurosis, free from cerebral complication, especially 
when due to alcohol or tobacco, it is very useful. In these cases 
strychnine is recommended in doses of gr. -h injected into the corre- 
sponding temporal region. It should be administered daily, and the 
dose increased until slight twitchings of the muscles are produced. In 
atrophy of the optic nerve-fibres, it has not met with the success which 
was predicted, but is of undoubted service before the stage of atrophy 
is reached. It has also been found very beneficial in chronic constipa- 
tion, either alone or as an adjunct to cathartics : !F^ Resinae podophylli, 
gr. iij ; extracti colocynthidis compositi, gr. xij ; extracti nucis vomicae, 
gr. vj ; extracti hyoscyami, gr. xxiv. M. et ft. pil. xxiv. Sig. — Take 
one pill once, twice or three times a day, as necessary. 1^ Aloini, gr. 
ij ; strychninae sulphatis, gr. % ; extracti belladonnae alcoholici, gr. j. 
M. et ft. pil. xxiv. Sig. — One pill after each meal, three times a day. 
As an aphrodisiac in impotence, in incontinence of nrine, spermatorrhoea, 
and other affections depending on functional atony and relaxation of 
muscular fibres, it is often highly serviceable; in dyspnoea due to chronic 
bronchitis, dilated bronchi, emphysema, or incipient p> hthisis , it is of value 
as a respiratory stimulant ; it may be advantageously combined with 
digitalis when dyspnoea is due to cardiac disease, acting not only as a 
respiratory, but also as a cardiac stimulant; and in pure cardiac dilata- 
tion it is well to alternate strychnine (gr. &\) with digitalis, giving either 
for a week or two at a time ; and lastly, in combination with other 
remedies, as iron, in ancemia and chlorosis ; Ify Strychninae sulphatis, gr. 
y^-% ; tincturae ferri chloridi, f5ij-iv; acidi acetici, diluti, f5j ; liquoris 
ammonii acetatis, f§iij ; elixir aurantii, ad f §vj. M. et S. — Two tea- 
spoonfuls, largely diluted, three times a day after meals. !r^ Ferri 
sulphatis exsiccati, gr. xx-5ss ; quininae sulphatis, gr. xl ; strychninae 
sulphatis, gr. ss., mannae q. s. M. ft. pil. xx. S. — One t. d. Strych- 
nine is a most valuable cardiac tonic in pneumonia with profound dys- 
pnoea and feeble heart-action and its hypodermic exhibition may be 
in such cases the best way of giving it. In small doses it has been 
used with excellent effect as a general tonic where there is loss of 
nerve-power, and as a stomachic in dyspepsia, chronic gastritis, ano- 
rexia, and to relieve the vomiting of pregnancy, for which purpose the 
tincture maybe given in TTL^-j doses, repeated several times at inter- 
vals of half an hour. 

In the treatment of the symptoms induced by alcoholismus, 



SPINA NTS— GOLDEN SEAL. 265 

Dobrowravow * reports good results from the hypodermic injection of 
strychnine, his observations extending over forty cases. 

Administration. — Dose of the powder, gr. ij or iij, in pill, sev- 
eral times a day, and increased till an effect is produced ; of the extract 
(extr actum nucis vomica) (alcoholic) gr. ss-j, to be repeated and in- 
creased ; of the fluid extract {extr actum nucis vomica fluidum), Tflj-v ; 
of the tincture [tinctura nucis vomica), gtt. v to xx, and this is some- 
times used as an embrocation to paralyzed parts. A tolerance of nux 
vomica and strychnine is rapidly established in the system. 

Strychnina {Strychnine). — The preparation and tests for this alka- 
loid have already been considered. 

The effects of strychnine are similar to those of nux vomica, but 
more violent. It is employed for the same purposes as nux vomica, 
and should be given in very minute doses, as gr. A— A (in granules) 
to begin with, to be gradually increased, carefully watching the patient 
and suspending its administration as soon as twitching of the muscles, 
or an approach to the risus sardonicus, is observed. The salts of 
strychnine may be also employed in the same doses, and as they are 
more soluble than the alkaloid, they are more active. For endermic 
use, gr. so of the alkaloid may be used ; when given hypodermically, 
as in amaurosis, dose, gr. in to begin with. The salts are preferred for 
hypodermic use, because of their greater solubility. 

Strychninae Sulphas {Strychnine Sulphate) (C 2l H 22 N 2 02)2H 2 S0 4 is 
made by dissolving a mixture of strychnine in distilled water, with 
diluted sulphuric acid and evaporating. It occurs as a white salt, in 
colorless prismatic crystals, efflorescent, odorless, very bitter, readily 
soluble in water, sparingly soluble in alcohol, and insoluble in ether. 
It responds to the tests for strychnine, and may be used for the same 
purposes and in the same doses. A good tonic, liquid form, is : 
1^ Strychninae sulph., gr. j ; acid, phosphorici dil.; aq. destillatae, aa f§i. 
M. S. f5J t. d. 

HYDRASTIS— GOLDEN SEAL. 

Description and Habitat. — The rhizome and rootlets of 
Hydrastis canadensis or Golden Seal {Nat. Ord. Ranunculaceae). Hy- 
drastis is a small indigenous plant ; with yellow, fugacious flowers, 
and a red fruit resembling raspberries. The rhizome is knotty, 
yellowish, and marked by transverse rings on its upper surface. 

Constituents and Properties. — It contains the alkaloids hydras- 

* Bull. Gen. de Therap., Dec. I5ieme, 1887, quoted. 



266 MATERIA MEDIC A AND THERAPEUTICS. 

tine (C 2l H 2l N0 6 ), I y 2 -2 parts per ioo ; berberine (C 20 H ir NOJ, 4 parts 
per 100, the yellow coloring matter of the root; canadine (C 21 H 21 N0 4 
in small quantity); and xanthopuccine (impure berberine),* besides 
volatile oil, bitter resin, vegetable acids, etc. Hydrastine occurs in 
white prisms, inodorous, of a bitter taste, insoluble in water, but mixing 
with alcohol. The hydrochlorate dissolves freely in water. (For the 
action of berberine see p. 147.) 

Incompatibles. — The vegetable and mineral acids may throw out 
the alkaloids from the liquid preparations. 

Aids. — Ergot on the uterus, and strychnine upon the spinal cord. 

Physiological Effects. — Applied locally to the nerves hydras- 
tine,f upon the presence of which the activity of the drug chiefly 
depends, produces anaesthesia. By direct application, the pupil is at 
first contracted, then dilated. Internally : mastication of the rhizome 
imparts a yellow color to the saliva, increasing its flow. Hydrastis is 
aromatic, its taste bitter and slightly astringent. No obvious consti- 
tutional results are observed after the ingestion of small quantities. A 
toxic dose induces vomiting, seemingly by gastric irritation. Accord- 
ing to Rutherford, it is a feeble gastro-intestinal excitant, and a hepatic 
stimulant of considerable power, augmenting the biliary flow. In the 
intestinal canal the alkaloids are dissolved out by the juices there 
found, and thence osmose into the blood. The residue, mostly vege- 
table fibre, passes on with the faeces. The volatile oil and resin 
are without obvious effect. Hydrastine, after absorption, resembles 
strychnine upon the nervous system, in that it increases the activity 
of the reflexes by an action on the spinal cord; but its effect is 
less powerful, though of longer duration than that of its congener. 
Sensibility is at first heightened ; then falls below the normal. The 
respiratory movements are primarily increased; but if a poisonous 
dose be swallowed, clonic convulsions set in, with loss of voluntary 
motion, general depression, death ensuing from tetanic arrest of respi- 
ration. Small doses are followed by increased cardiac action ; large, 
restrain the beats of the heart. The cardio-depressant effect is not 
interfered with by section of the pneumo-gastrics or medulla. The 
opinions of observers, however, differ as to the precise action of 
hydrastine with reference to the vascular system. But this much is 
certain, viz. : that as shown by Slavatinski,J when brought in contact 

* Proc. Amer. Pharm. Associat., 1884, p. 456; F. B. Power. 

f For a complete review of Hydrastis, see Bull. Gen. de Therapy 2, 1892, par Egasse. 

% London Med. Pec, Nov. 15, 1884, p. 498, quoted. 



SPINA NTS— GOLDEN SEAL. 267 

with the cut-out heart of the frog, it stopped, and could not be made 
to respond to further irritation. Heinricus considers it a powerful heart- 
poison. Hydrastine possesses some oxytocic power, though Giro- 
piszew* observed that the uterine contractions produced by it are 
less powerful than those of ergot. Fellner has seen energetic uterine 
contractions following the injection of the fluid extract of berberine 
and hydrastine. Giropiszew states, after numerous observations, that 
if given to pregnant rabbits, strong uterine contractions are seen to 
follow: A toxic dose causes slight fall of temperature. It is elimi- 
nated by the kidneys, somewhat augmenting the quantity of the urine. 
.Toxicology. — The minimum fatal quantity of hydrastine, in dogs, 
is 50 centigrams per kilo of weight, administered by hypodermic 
injection. The autopsy revealed pulmonary congestion and extrava- 
sation of bile. 

Medicinal Uses. — It is recommended empirically in the dyspepsia 
of females characterized by pain, a sense of weight about the epigas- 
trium, nausea, constipation, with nervousness and leucorrhcea, the 
tincture to be taken 3 or 4 times daily between meals. From its action 
on the liver and intestines it may be useful in catarrhal jaundice due 
to deficient secretion. Professional experience favors its exhibition 
given at short intervals, in uterine hemorrhage ', due to inflammation 
of the organ, or to that coincident with the menopause , or a too abund- 
ant flow at the monthly period (Giropiszew and Boissi), the beneficient 
action of the remedy being attributed to the diminution of hypersemia 
of the internal genital organs, due to contraction of the afferent ves- 
sels. R. W. Wilcox relates 43 cases of uterine hemorrhage, from 
various causes, as fibroma, involution, etc., in which hydrastis arrested 
the flow and relieved the pain. It has been employed topically directly 
to the vagina in leucorrhoea. As an injection in gonorrhoea and gleet 
hydrastine may be used in the strength of gr. x-xv to mucilage f§i. 

Hydrastininae Hydrochloras {Hydrastinine hydrochlorate) (C n H n 
N0 2 HC1), added to the U. S. P. of 1890, is an artificial alkaloid derived 
from hydrastine. It is a yellow, crystalline powder, of a bitter saline 
taste, and very soluble in water. It causes uterine contractions, par- 
alyzes the motor tracts of the cord, and increases the cardiac contrac- 
tions. Dose, gr. J^ in capsule ; used in uterine hemorrhage. 

Administration. — Dose of the fluid extract {extractum hydrastis 
fluidum), f5^-iv; as a stomachic tonic, 1Tlv-xv before meals; of the 

* These, St. Petersburg, quoted. 



268 MATERIA MEDICA AND THERAPEUTICS. 

tincture (tinctiira Hydrastis) the dose is 1TLx-f5i, t. d.; a glycerite {glycer- 
itum Hydrastis) is also official. The following is a good injection in 
gonorrhoea, being non-alcoholic and without precipitation : ^ Ext. 
Hydrastis fid. (aqueous), f Si ; cocainae hydrochloratis, gr. ij ; aq. des- 
tillatae, q. s. ad f5vi. M. S. Injection, t. d. 

Rhus Toxicodendron (Poison-Ivy). — The FRESH LEAVES of Rhus 

radicans {Nat. Ord. Anacardiae), an indigenous shrub from one to 
three feet high. 

Chemical Constituents. — The fresh leaves contain an acid juice 
and toxicodendric acid, the latter seeming to be the active principle ; 
it is by Pettigrew considered to be impure formic acid. 

Effects and Uses. — The acrid juice of the leaves is vesicant, 
setting up when applied to the skin, inflammation. Internally, rhus 
causes gastro-intestinal inflammation and stupor. It has been given 
in paralysis. 

Toxicology. — The eating * of the root recently killed five boys, 
the symptoms being stupor, dilated pupils, nausea, convulsions and 
collapse. In cases of dermal poisoning the irritation of the skin is 
relieved by glycerite of carbolic acid or alkaline lotions. 

Administration. — Dose, gr. i-iij, or more, to be repeated and 

increased. 

cocculus indicus. 

Description and Habitat. — Cocculus indicus (not official) is 
the dried seed of Anamirta paniculata {Nat. Ord. Menispermaceae), a 
climbing shrub of India. The fruit is a one-celled berry, of a dark 
purplish color, with a soft pulp, and a single seed the size of a pea, 
containing a bitter kernel. 

Chemical Constituents. — The active properties reside in a 
peculiar white, crystallizable bitter-principle which is official under the 
name of picrotoxinum {picrotoxin) (C 30 H3 4 O 13 ). It is partially soluble 
in water, and very soluble in alcohol, chloroform and ether, and in a 
mixture of acetic acid and water. Picrotoxin is not precipitated by 
the reagents for the alkaloids, and does not neutralize acids. In the 
shell, an alkaloid termed menispermine has been found, and a neutral 
principle of the same composition as the alkaloid, termed parameii- 
ispermin. 

Aids. — The spinants, as strychnine, brucine, and ergot. In its 
action on the secretions, it is allied to pilocarpia and muscarine. 

* Med. Record, N. Y., June 9, 1894. 



SPINA NTS—ER GOT. 269 

Physiological Effects. — Locally, it is said to prevent the secondary 
fermentation of malt liquor; and it has parasiticidal virtues. The 
taste of picrotoxin is very bitter, and it excites the salivary flow. It 
does not irritate the gastro-intestinal tube, and diffuses readily into 
the blood. It is said to induce diaphoresis, though this is denied. It 
is an acrid cerebro-spinal narcotic, capable, in large doses, of 
producing death by tetanic fixation of the respiratory muscles. Its 
cerebral effects are variously described, such as stupor, giddiness and 
vertigo. In doses sufficient to produce these effects it is apt to 
nauseate. It is a tetanizing agent, the tetanus being followed by con- 
vulsions, paralysis and coma. According to Chirone* the chief 
action of the drug appears to be that of an excitant of the centres 
located in the medulla oblongata and spinal cord. The convulsions 
can be brought on in an animal from which the brain has been 
removed. Picrotoxin is capable of originating an artificial epilepsy, 
and it acts independently of the psycho- motor centres, its influence 
being most decided when they are removed. During the conclusive 
stage the heart's action increases, while in the stage of coma it 
becomes slow, and after death it is found to be in diastole. 

Toxicology and Antidotes. — In rare instances it has destroyed 
human life. In cases of poisoning by picrotoxin, chloral, ether by 
inhalation, and the motor-depressants are to be given. 

Medicinal Uses. — Picrotoxin has not been much used internally, 
except in the night-sweats of phthisis, for which Murrellf recommends 
it, in doses of gr. -io~Tu- I n the form of the decoction or ointment 
(gr. v to §i) it is employed to destroy pediculi and other parasites, and 
for the cure of tinea capitis and porrigo of the scalp. Of the seeds 5i 
to lard Si. 

ERGOTA— ERGOT. 

Description. — Ergot is a fungus growing from the diseased ovary 
of Secale cereale, or Rye {Nat. Ord. Graminaceae). The U. S. Phar- 
macopoeia styles it the Sclerotium of Claviceps Purpurea {Class 
Fungi), replacing the grain of Secale cereale. {Nat. Ord. Gramineae). 

Stages of Formation. — In the production of ergot there are 
three stages, as follows : 1st, in the flowering season one or more 
ovaries in an ear of rye are covered by a sweet yellowish mucus — 

*Annali Unive?-. di Med. e Chirurgia, vol. 251, 1880, p. 289. Ricerche sperimentali 
sull'azione biologica della picrotoxina; per V. Chirone; also Arch. f. exper. Pathol, u. 
Pharm., R. Gottlieb, 1892, p. 21. 

t Lancet, London, 1 890. 



270 



MATERIA MEDIC A AND THERAPEUTICS. 



the honey dew of rye — which contains numerous microscopic cells 
called conidia, a sugar, and which is the product of the decomposition 
of the constituents of the ovary caused by the developing mycelium 
of the fungus. This is formed of filamentous cells termed hyphce, and 



Fig. 22. 




SECALE CEREALE. A, A, ERGOT. 



the first stage ends when the hyphae have penetrated the ovary and 
separation of the conidia has ceased. 2d, when the hyphae unite at 
the base of the ovary into a purplish-black body (ergot) extending to 
the apex of the grain. 3d, the development of the fungus is com- 



SPINA NTS—ER GOT. 271 

pleted. It will be seen that ergot is the dormant or intermediate stage 
of a fungus called Sclerotium, compound mycellium or spawn. Its 
predisposing cause is unknown, and it is not peculiar to rye, many 
other grasses being subject to it, as abortion in grazing animals has 
been frequently produced by their eating grasses affected with ergot. 
The ergot usually projects out of the glum or husk of the plant, 
beyond the ordinary outline of the spike or ear. It should not be 
collected until some days after it has begun to form, as it is thought 
not to possess full activity until about the sixth day of its formation. 
After one year it is unfit for use. 

Properties. — As found in the shops it consists of cylindrical or 
somewhat prismatical, tapering grains, curved like the spur* of a cock, 
of a purplish color externally, and of a yellowish or grayish-white 
color within. Its smell is peculiar and nauseous ; its taste is at first 
faint, but becomes oily and disagreeable. It yields its virtues to water 
and alcohol, and does not keep well, being liable to the attacks of a 
minute worm, which may be prevented by dropping on the fungus a 
little chloroform. It deteriorates much more rapidly in powder than 
when in grain, in the former condition soon becoming inert. 

Chemical Constituents. — Numerous analyses have been made 
of ergot, but there is still some uncertainty as regards its active prin- 
ciples, though this is gradually growing less. The investigations of 
Dragendorff seem to show that the specific effects of the drug depend 
in a high degree upon a proximate principle of an acid character, to 
which the name of sclerotic acid (C 12 H 19 N0 9 ) is given : this, however, 
has not been confirmed. It is odorless and tasteless, soluble in water 
and boiling alcohol, but not at all in cold alcohol. Good ergot con- 
tains from 4 to 4.5 per cent, of the acid. The most reliable investiga- 
tions upon this question are those of Kobert,* which point to the fol- 
lowing conclusions : viz., that ergot does not owe its ecbolic power to 
ergotinic acid, which has no influence on the uterus, but that sphace- 
linic acid, a resinous body insoluble in water, never failed to produce 
powerful contractions in the gravid uterus, and lastly that cornutin (an 
alkaloid, poisonous), gr. */£, either in the pregnant or non-pregnant 
uterus, always exhibited the same action. According to this observer, 
the only active preparation is one containing both cornutin and 
sphacelinic acid, and that no sample of ergot, either European or 

* The Practitioner, Dec, 1885, p. 414: and Arch, fur exp. Pathol, u. PharmakoL, 
1884, xvii, p. 316. 



272 MATERIA MEDIC A AND THERAPEUTICS. 

American, retained its virtues for more than 12 months. Ergot also 
contains scleromucin (2 to 3 per cent.), sclererytherin, scleroiodin, pic- 
rosclerotin (poisonous), sclerocrystallin, and scleroxanthin (inert), and an 
inert alkaloid, ergotinine (C 35 H 40 N 4 O 6 ). 

Incompatibles. — Forms a clear solution with liquor potassae ; 
tannin throws down a copious precipitate ; with ferric chloride its solu- 
tion is much darkened. 

Aids. — Ustilago and gossypium enhance its action of contraction 
upon the uterus. 

Physiological Effects. — Its taste is oily and disagreeable. The 
effects of ergot are not well understood, especially as regards its action 
on the nervous system. In medical doses it acts most conspicuously on 
the circulation and on the female system, in which it excites powerful 
contractions of the uterus. After labor has commenced, in ten or twenty 
minutes from its administration, it increases the violence, frequency 
and continuance of the labor-pains, which usually never cease until 
the child is born. Administered before labor, it frequently originates 
the process, though its effects in this respect are less constant. And 
even in the unimpregnated uterus it produces painful contractions, and 
evinces an influence over morbid conditions of the organ by checking 
uterine haemorrhage and expelling polypi. Ergot induces* contraction 
of the unstriped muscular fibre wherever found, causing a shrinkage 
in the calibre of the blood-vessels everywhere, and it is thus available 
generally as a remedy in cerebral and spinal congestions, haemorrhages, 
tumors, morbid growths and enlargements. In large doses it produces 
vomiting, purging, increased peristalsis, and a marked sedativef effect 
on the circulation, slowing the heart (10-36 beats), probably by direct 
action on the cardiac muscle, and causing an enormous rise in the 
blood-pressure, through the contraction of the arterioles and stimula- 
tion of the vaso-motor centres of the cord and medulla; decided 
toxic doses lower the blood-pressure, by depressing the heart and vaso- 
motor centres (Brown-Sequard). 

Toxicology and Antidotes. — In excessive quantities it acts as an 
acro-narcotic poison on both sexes. Tannin and stimulants are the 
antidotes. When it is used for a length of time as an article of food 
it produces a peculiar morbid condition, termed ergotism, which 

* Arch, de Physiol. Norm, et Pathol., iii, 1870, p. 584. Effets de P extrait d' ergot 
sur la pression arterielle ; par Ch. L. Holmes. 

f Bull. Gen. de Therap., lxxviii, pp. 433, 481. Ergot, ergotine, action physiol., etc. 
M. Bailley. 



SPINANTS—ERG O T. 273 

assumes two forms, one attended with convulsions, the other with dry 
gangrene of the limbs. 

Medicinal Uses. — From its action on the pregnant uterus, ergot 
has long been used in obstetric practice. With few exceptions ergot 
had better not be administered while any product of conception re- 
mains within the uterine cavity, because, while causing contraction of 
the muscular fibres of the fundus, which would produce expulsion of 
the uterine contents, it also causes contraction of the sphincter-like 
fibres of the cervix, and thus presents an obstacle to the emptying of 
the uterus. As the intermittent contractions of the uterus become 
continuous and tetanic under the influence of a large dose of ergot, it 
is obvious that rupture of the uterus may occur if the resistance offered 
to the expulsion of the uterine contents be sufficiently great. Partly 
on this account, and partly because the tetanic contraction of the uterus 
induced by ergot would interfere with the circulation of the fcetus, it 
should never be administered during the first stage of labor. During 
the second stage of labor, it may be given if the expulsive pains are 
feeble and inefficient (uterine inertia), when there is a proper conformation 
of the pelvis and soft parts, when the os uteri, vagina, and os externum 
are dilated or readily dilatable, and when the presentation of the child is 
such as to offer no great mechanical impediment to speedy delivery. In 
these cases it is best to administer it in small doses (TTLviij-x of the 
fluid extract), as when thus given it simply intensifies the natural 
uterine contractions without causing them to become continuous. It 
has also been used in the second stage of labor in women subject to 
flooding, given just before delivery"; but even in these cases it is better 
to withhold the drug until the placenta is expelled, as otherwise the 
uniform contraction induced may lead to its retention. 

After the third stage of labor is completed, if hemorrhage is likely 
to occur from uterine inertia, ergot is one of the best remedies we 
possess, as the tetanic contractions which it produces permanently 
arrest the bleeding by compressing the orifices of the vessels. Ergot 
exercises a dangerous sedative influence on the child during labor 
(owing to the interference of the passage of blood from the placenta 
during violent uterine contraction), and its use may sometimes produce 
fcetal'death, if the obstetrician is not careful to listen frequently to the 
foetal heart, and deliver with the forceps should any sign of asphyxia 
be present (Spiegelberg). It has been used in the haemorrhage due to 
abortioii, but as the bleeding will only stop when the uterine cavity is 
empty, and as ergot delays this by preventing dilatation of the cervix, 
18 



274 MATERIA MEDIC A AND THERAPEUTICS. 

the tampon and other means are preferable. When, after an abortion, 
the placenta is retained by adhesions so firm that it is impossible to 
destroy them, a tampon may be employed and ergot given simulta- 
neously. 

Ergot has also been used to cause the expulsion of polypi, and 
even of interstitial fibroids from the uterus. In speaking of its adminis- 
tration in the latter class of tumors, Emmet* says : " It should never be 
given in large doses until after the uterine canal has been dilated, and 
until it is found that the tumor projects sufficiently to warrant the 
belief that it may become pedunculated by uterine contraction." By 
neglecting these cautions he has seen peritonitis produced. It is best to 
administer it hypodermically in these cases. In subinvolution , especially 
when menorrhagia is present, ergot combined with potassium bromide, 
is useful. For its action on unstriped muscular fibre it is much 
employed in hemorrhage generally; in congestive dysmenorrhea ; hem- 
aturia; paralysis of the bladder, especially when due to over-distention ; 
purpura; and diabetes insipidus ; by hypodermic injection, in the cure 
of varix, and as a means of checking hemoptysis, though as it raises 
the pulmonary blood-pressure its exhibition is irrational. It is also 
used in intestinal and uterine hemorrhage. In hematemesis, ergotine 
gr. ij may be given hypodermically. In paralysis dependent upon con- 
gestion of the spinal cord, as in spinal meningitis, and in acute myelitis, 
it is often of great service. 

Administration. — Ergot may be given in labor, in the dose of 
gr. v-xx, in powder, every twenty minutes, till its effects are produced, 
or three doses are taken: in other diseases the dose is from gr. iij-x. 
It may be safely given, in chronic diseases, for a long period, without 
danger of ergotism ; the indication of the maximum dose having been 
reached in the female is the production of uterine colic, when the 
quantity should be diminished. The fluid extract (extractum ergote 
fluiduni) is the best preparation ; dose 1T[v-f5j or more.f The extract 
(extractum ergote) is made by the evaporation of fluid extract over a 
water bath at a temperature not exceeding 122° F., until it is reduced 
to a pilular consistence ; dose, gr. v-xv. The wine (vinum ergote) 

* " Princip. and Practice of Gynaecol." 3d ed., p. 567. 

t For hypodermic^use, the fluid extract should be reduced by evaporation to one-sixth 
of its weight, and sixty grains of this extract should be dissolved in four fluidrachms of 
water ; four minims of this aqueous solution represent one grain of extract and six grains of 
ergot; or the fluid extract may be carefully filtered, and used in doses of TTL X » or tne ex_ 
tract may be dissolved in water and filtered ; it is five times as strong as the fluid extract. 



SPINANTS—BARK OF COTTON ROOT. 275 

contains powdered ergot, 15 parts, in 100 parts by weight of the pre- 
paration ; dose, f5j-iv. The preparations used under the name of 
ergotine, the purified extract, are of uncertain strength. Bonjean's 
(an aqueous extract) is given in the dose of gr. ij-v, either in pill, 
capsule, syrup, or hypodermically. 

GOSSYPII RADIC1S CORTEX— BARK OF COTTON ROOT. 

Description and Habitat. — Gossypium herbaceum (Nat. Ord. 
Malvaceae) is a native of Asia, cultivated extensively in tropical and 
semi-tropical countries, and with great success in the South Atlantic 
and Gulf districts of the United States. By cultivation, different 
varieties of this plant have been produced. The root should be 
collected immediately after the cotton is harvested. 

Properties and Constituents. — The root-bark, which comes 
in quilled pieces, should be of a yellowish-brown color externally, 
internally much lighter. It contains chromogene (when fresh), 
becoming a red resin, a yellow resinous coloring matter, fixed oil, gum, 
sugar, tannic acid, etc. 

Aids. — Upon the uterus ergot and ustilago. 

Effects and Uses. — When chewed, it has a slightly sweetish, 
astringent taste. Gossypium has long been recognized by Southern 
physicians as possessing a decided influence in exciting uterine con- 
tractions. Dr. J. C. Martin,* from experiments on frogs, rabbits, and 
guinea-pigs, concludes that it has no action on the motor or sensory 
nerves, nor on the reflex functions, and that the circulation and 
muscles are uninfluenced by it. 

The most recent investigations, furthermore, show that in large 
doses it kills by paralysis of respiration, often preceded by clonic 
convulsions not prevented by section of the cord ; the reflex centres 
of the cord are depressed, but the motor and sensory nerves are not 
affected. The blood-pressure falls, from depression or paralysis of 
the vaso-motor centres, this fall being preceded by a rise in 
pressure if the dose be small. In large amounts it causes great venous 
congestion and tension, stimulates and then paralyzes the cardio- 
inhibitory apparatus and depresses the cardio-motor ganglia, thus at 
first retarding and then accelerating the pulse, which is always 
weakened. The pupil is always dilated. It stimulates muscular 
action, especially that of the unstriated variety. It often causes 

* Am. Journ. Med. Sciences, Jan., 1882. An investigation of the physiological effects 
of Gossypium Herbaceum. 



276 



MATERIA MEDICA AND THERAPEUTICS. 



vomiting and purging. In cats and rabbits, gossypium causes, in 
small and repeated doses, intermittent rhythmical contractions of the 
gravid uterus, leading to complete expulsion of its contents, and it has 
been seen to increase the uterine contractions when administered after 
their inception.* Prochovnik finds it an efficient substitute for ergot, 
although its expulsive power is not so great. He recommends it 
especially in haemorrhage after abortion, and in uterine myoma. 

Administration. — The only official preparation is the fluid extract 
(extr actum gossypii radicis fluiduni) ; dose, f 5ss. 

DIGITALIS— FOXGLOVE. 

Description, Habitat and Preparation. — Digitalis purpurea, or 
Purple Foxglove (Nat. Ord. Scrophulariaceae), is a biennial European 
plant, cultivated in our gardens, with an erect stem three or four feet 
high, large ovate-lanceolate, crenate, downy and veiny leaves, of a dull- 
green color, and handsome bell-shaped crimson or purple flowers, 
arranged in a large terminal spike. The seeds and leaves are both 
active, but the latter only are employed, from plants of the seco?id year's 
growth; and those from the European wild plants are preferred, as the 

Fig. 23. 




DIGITALIS PURPUREA. A. LEAF; B. FLOWERS. 



*" Gossypium Herbaceum." Thesis by Thos. Harry Huzza, M.D., awarded the 
Medical News prize at the Jefferson Medical College, of Philadelphia, 1887. 



SPINA NTS— DIGITALIS— FOXGL O VE. 277 

cultivated variety is thought to be inferior in virtue. The English 
digitalis-leaves are superior to the German because they are carefully 
selected and freed from the stalks, which do not represent the activity 
of the plant. The petioles are removed, and the leaves are then dried 
in baskets, in a dark place, in a drying-stove. 

Properties. — When dried, they have a dull-green color, with a 
faint odor and a nauseous taste, and afford a fine deep-green powder. 
Both leaves and powder should be preserved in well-stoppered bottles 
covered externally with dark-colored paper, and kept in a dark cup- 
board, and, as their medicinal activity is impaired by keeping, they 
should be renewed annually. 

Chemical Constituents. — The leaves contain numerous so-called 
principles, among which are digitalin, digitoxin, digito?tin, and digi- 
talein ; many of these are the result of decomposition, either during 
plant-life, or during the treatment of the extract or exhaustion of the 
plant. They are all glucosides except digitoxin. By digitalin is meant 
the product obtained by Schmiedeberg in 1874. The digitalis-prin- 
ciples may be arranged according to their solubility ; viz., those soluble 
in alcohol and almost insoluble in water (digitalin and digitoxin) ; and 
those miscible both in alcohol and water (digitonin and digitalein). 
Consequently such preparations as the tincture and fluid extract con- 
tain the most digitalin and digitoxin; the infusion, digitonin and digi- 
talein. Digitonht is said to resemble saponin, but differs from it in its 
behavior to chemical reagents. The other constituents are inosit, pectin, 
resin, the digitalic acids, and fixed oil (about 5 per cent.). Digitalin and 
digitoxin are the most active ingredients of the plant. 

Digitalin (not official), when perfectly pure, occurs as fine, white, 
glittering hygroscopic needles, or groups of crystalline tufts, odorless, 
but of a very bitter taste ; readily soluble in alcohol, chloroform and 
warm acetic acid, but nearly insoluble in water and ether. A dose 
above gr. tV causes purging and vomiting. 

Tests. — Chemical analysis affords no certain tests of the presence 
of digitalis or its active principle, even Grandeau's method of isolating 
digitalin by dialysis being uncertain, and in cases of suspected poison- 
ing the physiological test must be resorted to. This, however, is not 
proof positive of its presence, for Fagge and Stevenson * have shown 
that digitalis is only one of a small class of substances (as helleborus 



* Proc. Royal Society, XIV, p. 270. On the application of Physiological Tests for Cer- 
tain Organic Poisons, especially Digitaline. 



278 MATERIA MEDICA AND THERAPEUTICS. 

viridis and scilla) the action of which on the frog's heart appears to 
be identical. These they termed cardiac poisons. In every experi- 
ment they caused cardiac irregularity, followed by stoppage of its 
pulsations in rigid ventricular contraction. In the celebrated Pommerais 
case, the criminal was condemned from the evidence derived from the 
administration of an extract obtained from the stomach and bowels of 
the deceased party, to small animals, in whom were produced vomiting 
and marked diminution of the number of heart-beats, with intermittent 
and irregular action. 

Incompatibles. — Forms an inky mixture with ferric chloride and 
sulphate ; with compound tincture of cinchona and tannin a precipitate 
goes down ; lead subacetate and acetate produce a copious precipitate. 
The precipitation with the iron and lead salts is due to combination 
with the digitalis-acids. 

Aids. — Upon the heart and vessels, adonidin, strophanthus, spar- 
teine, cimirifuga, and ergot. 

Physiological Effects. — The taste of digitalis is bitter and nau- 
seous. Small doses are without obvious effect on the gastro-intestinal 
tract ; large, produce nausea and vomiting. Though the action of digitalis 
is directed chiefly to the circulatory apparatus, yet in lethal quantity 
other phenomena are induced, as follows. Nervous system : in toxic 
doses, digitalis lowers reflex activity by exciting Setschenow's inhibi- 
tory reflex centre, and, after a time, paralyzing the spinal cord (A. Weil), 
causing prostration, muscular tremors and sometimes convulsions. 
Circulation : its action here has been investigated by Vulpian, Pelikan, 
Homolle,* Gaskell f and others, with the following results, viz. : that 
it lessens the number of cardiac pulsations, prolo7iging the diastole, 
energizing the systole, and finally paralyzing the heart in systole ; this is 
produced by direct stimulation % of the cardiac muscle, and possibly of 
the contained motor-ganglia, as well of the peripheral inhibitory fibres 
of the pneumogastric. Moderate doses cause a rise in the arterial 
pressure, probably by contracting the arterioles, through stimulation 
of the vaso-motor centres of the cord ; after large doses the pulse be- 
comes dicrotic from irregular ventricular contraction ; toxic doses, or, 

* Arch. Gen. de Medecine, xviil, p. 5. Exper. physiol. sur quelques preparat. de 
digit ale. 

| The Journ. of Physiology, III, p. 48. On the Tonicity of the Heart and Blood 
Vessels. 

\ Proc. of the Royal Med. and Surg. Soc, I, 1882-5. Investigations into the Action 
of the Digitalis Group. Ringer and Sainsbury. 



SPINANTS— DIGITALIS— FOXGL O VE. 279 

when the heart is much depressed, a sudden change from the recum- 
bent to the erect position, may cause a frequent, weak and small pulse, 
with lowered blood-pressure. An entirely satisfactory explanation of 
the modus operandi of digitalis on the circulatory apparatus has not so 
far been made. The influence of digitalis over the pulse is more 
marked in weak and debilitated persons than in those who are robust 
and plethoric. Its effects, too, in this particular are more easily ob- 
tained in the recumbent than in the erect posture, owing to the less 
force required in the former position to carry on the circulation. In 
morbid conditions of the circulation, where it is irritable, abnormally 
quick or irregular, digitalis is considered to exercise a primary medici- 
nal effect in steadying the pulse and restoring its force and regularity, 
while it diminishes morbid frequency. Where the temperature of the 
body is abnormally increased, digitalis, in large doses, will diminish it. 
From its action on unstriated muscular fibres, digitalis has the property 
of stimulating the uterus to contraction. As regards its diuretic action, 
it is probably rather indirect than direct, and is most conspicuous where 
dropsical effusions are removed under its influence. Brunton * has, 
however, shown that in dropsies it acts directly on the Malpighian 
tufts, independently of the blood-pressure; also, that when taken for a 
long time, and accumulating in the blood, it diminishes the urinary 
flow by contraction of the renal vessels. It increases the amount of 
solids eliminated in the urine, except the urea and uric acid, which 
are diminished under its use. In health, the action of digitalis upon 
the quantity of urine is uncertain. 

Toxicology. — When too long continued, or taken in excessive 
doses, digitalis acts as an acro-narcotic poison, producing vomiting, 
purging, irregular, feeble and rapid cardiac action, severe abdominal 
pains, vertigo, disordered vision, dilated pupils, syncope, and, finally, 
delirium and stupor, death being usually preceded by convulsions. The 
quantity of digitalis, however, that may be given, especially in disease, 
without destroying life, is considerable. According to Woodman and 
Tidy about gr. y^ of digitalin would prove fatal, and a toxic amount 
rarely kills in less than 24 hours. 

Antidotes. — In such cases, after evacuating the stomach, the 
diffusible stimuli, as brandy and ammonium carbonate, should be ad- 
ministered. Opium, aconite, etc., antagonize to some extent the action 



* Pharmacology, Mat. Med., and Therap., 1885, p. 915 ; also Arch. f. exper. Pathol, 
u. Pharm., Dr. F. Pfaff, 1893, p. I. 



280 MATERIA MEDICA AND THERAPEUTICS. 

of digitalis; the most complete antagonism exists between digitalis and 
saponin, the active principle of Saponaria officinalis (Kohler). 

Medicinal Uses. — From its action on the circulation, digitalis 
has been used in adynamic fevers and inflammations, and in haemor- 
rhages, especially that of Menorrhagia, and in post-partum haemor- 
rhages. In hectic fever, it is often combined with quinine, and if it does 
not disorder the digestion, it is generally of great value : 1^ Quininae 
sulphatis, gr. xxiv ; pulveris digitalis, gr. viij ; pulveris opii, gr. vj. 
M. et ft. pil. xxiv. Sig.— Take one pill 3 or 4 times a day. In fevers 
accompanied by a high temperature and heart failure, as scarlatina and 
typhoid fever, it is useful. In the treatment of diseases of the heart 
and great vessels, it is a remedy of the greatest value, but is to be pre- 
scribed with discrimination. In dilatation of the heart, with broken g 
compensation, in fatty degeneration, and in irritability of heart-action 
generally, digitalis, by increasing the force of the cardiac contractions 
and by abating irregular movement, is nearly always useful ; in un- 
complicated hypertrophy it is objectionable. In valvular regurgitation, 
aortic or mitral, if the heart's action be feeble, or in case of failure of 
compensation its administration is called for, particularly if accom- 
panied by dyspnoea and dropsy, and when so indicated it should be 
given in doses large enough to produce its physiological effects, viz., 
to increase the force, but reduce the number of pulsations, to raise the 
arterial tension, and augment the urinary flow. At the same time the 
bowels must be kept freely opened with the hydragogues, and suffi- 
cient rest in the recumbent position enjoined as the case may seem to 
require. In aortic constriction, if the heart's action be feeble, it is indi- 
cated. An approved formula as a cardiac tonic is : 1^ Infus. digitalis, 
fgv, f 04 j£ ; tinct. belladonnas, f5j ; tinct. strophanthi, foiss ; sol. 
nitroglycerine, I per cent., TH48. M. S. Teaspoonful in a little water, 
t. d. In cases of sudden sy?icope from any cause, a hypodermic injec- 
tion of the tincture TT|.x-xx, repeated, if necessary, in half an hour, 
may be advantageously administered. H. C. Wood states that he has 
never seen any severe local irritation follow this use of the tincture, 
which accords with the observations of others in several cases. 

It is greatly esteemed in the treatment of ascites and dropsy ; and 
in the varieties of this disorder resulting from heart-disease the infu- 
sion of digitalis is more employed than any other remedy, from its 
combined cardiac and diuretic influence. In these conditions it may 
often be advantageously combined with iron. 3^ Pulveris digitalis, 
gr. xv ; ferri sulphatis exsiccati, gr. x ; quininae sulphatis, gr. xx ; 



SPINANTS—ADONIDIN. 281 

oleoresinae capsici, gr. iij. M. et ft. pil. xx. Sig> — Take one pill 
three times a day ; or the infusion may be alternated with a mixture 
containing tincture of ferric chloride. In the stage of effusion in 
pericarditis, the infusion with potassium acetate may be of service. It 
is a valuable remedy in acute Brighfs disease, especially when dropsy 
is present, and also in chro?iic Brighfs disease of the kidney under like 
circumstances. In delirium tremens digitalis has been given in large 
doses, with excellent effect, and it occasionally proves efficient as a 
heart-tonic in that obstinate condition known as exophthalmic goitre. 
Administration. — Digitalis may be given in powder (or in pills 
with confection of rose), of which the dose is gr. j two or three times 
a day, to be gradually increased. The official preparations are : the 
infusion {infusum digitalis) (powdered digitalis 15 parts macerated in 
500 parts of boiling water until cold, then strained, and 100 parts of 
alcohol and cinnamon water 150 parts passed through the strainer, and 
water enough to make 1000 parts), dose, f5ij-iv ; the tincture {tinctura 
digitalis), dose, TTLv-fSj ; the extract {extr actum digitalis) (alcoholic), 
dose, gr. ^, gradually increased; the fluid extract {extr actum digitalis 
fluidum), dose, TTLj to begin with. The tincture, extract and fluid 
extract may be had in the form of tablet triturates. If digitalis pro- 
duce wakefulness, a little opium may be combined with it. Digitalin, 
dose, gr. sib-A in granules. 

ADONIDIN. 

Description and Habitat. — Adonidin (not official) is a glueo- 
side, obtained from the root of Adonis vernalis {Nat. Ord. Ranuncu- 
laceae), a plant of central Europe. 

Properties. — It was first isolated by Cervello,* and is an amor- 
phous substance, hygroscopic, odorless, colorless, but having an in- 
tensely bitter taste, soluble in alcohol, but slightly soluble in ether and 
water.f 

Aids. — See digitalis. 

Physiological Effects. — Adonidin is almost identical in action 
with digitalis,! strengthening the cardiac energy, while diminishing its 
frequency by prolonging the diastole, thus allowing the engorged veins 

* Archiv. filr experiment. Pathol, und Pharmakol., 1882, p. 338. 

f " Poisons; their Effects and Detection," by Alexander Wynter Blyth. Am. Ed., 
p. 396. 

JV. Cervello, op. cit. and La Med. Contemp., July and Aug., 1885. E. Durand, 
Journ. de Med., Dec., 1 885, and These de Paris, 1886, Bubnow. Centralbl. fur die ges- 
ammte Therapie, 1885. Houchard, Gaz. Hebdomadaire, Jan. 1st, 1886. 



282 MATERIA MEDICA AND THERAPEUTICS. 

time to empty themselves, and at the same time raising the arterial 
tension by contracting the arterioles. It acts more quickly on the 
heart than digitalis, and is not so apt to disorder the stomach and 
bowels (Cervello, Durand), although these effects are sometimes 
observed. 

According to most authorities it possesses considerable diu- 
retic powers, increasing both the water and the solids of the urine. 
It is rapidly eliminated, and has no cumulative action (Cervello). 
According to Hare,* in all doses it heightens the arterial tension by 
stimulating the vaso-motor centres and increasing the force of the 
cardiac contractions ; large doses slow the heart by stimulating the 
vagus, which finally becomes paralyzed, the pulse rate being then 
accelerated. 

Medicinal Uses. — Adonidin may be used for the same purpose 
as digitalis, particularly in mitral regurgitation, to which, however, it is 
inferior. When the latter is contraindicated from some idiosyncrasy 
on the part of the patient, or when it disorders the stomach, or if its 
action be not sufficiently rapid, adonidin may be substituted with 
advantage. It may, too, be alternated with digitalis, giving either for a 
few weeks at a time. 

Administration. — Dose, gr. y^-yi in compressed pill or capsule. 

STROPHANTHUS. 

Description and Habitat. — Strophanthus is the seed of the 
Strophanthus hispidus {Nat. Ord. Apocynacae), deprived of its long 
awn, a plant distributed along the coast of Africa, between Senegambia 
and Lower Guinea. It is described by Blondel f as a climbing shrub, 
ascending the highest trees and hanging from one tree to another like 
a bush-vine, which gives off yellowish-white flowers, arranged in hairy 
cymes. The seed is contained in a thin, cylindrical pod, the length of 
which varies between 25 and 50 centimeters. 

Properties. — They are from 10 to 14 millimeters in length, 4 to 
5 broad, " oblong-lanceolate, flattened and obtusely-edged, grayish- 
green, covered with appressed silky hairs." Seeds without a hairy 
surface should be discarded. The quality and appearance of the seeds 
of commerce vary. These seeds, coarsely powdered and made into a 
paste, are used by the natives to poison their arrows, and are called 
Combe, Kombe, or Inee. 

* Therap. Gaz„ Apr. 15th, 1886. 

f Bull. Gen. Therapy Fevrier, 1888, p. 97. 



SPINA NTS— SPARTEINE. 283 

Chemical Constituents. — From strophanthus Dr. Thomas B. 
Fraser * has isolated a crystalline glucoside, which he calls strophan- 
thin (C 16 H 26 8 ), and to which the effects of the seed are due. It has a 
feebly-acid reaction, and is freely soluble in water, and in rectified 
spirits. 

Aids. — Digitalis, adonidin, and sparteine. 

Physiological Effects. — Pelikan in 1865 called attention to stro- 
phanthus as a powerful cardiac poison, and his researches were con- 
firmed by Fraser,f Corville,| and others. Strophanthus has a strong, 
bitter taste. When introduced into the system it increases the strength 
of the cardiac systole, while prolonging the diastole, and in over-doses 
arrests the heart in rigid systolic contraction. It is a muscle-poison, 
increasing the contracting power of all the striated muscles, and ren- 
dering their contractions more complete and prolonged, but the heart 
is easier influenced by it than are other muscles, and the dose may be 
so regulated that the cardiac effects are alone produced. It also con- 
tracts the arterioles somewhat, but not to the same extent as does digi- 
talis. It produces a slight lowering of temperature and is a diuretic, § 
It rarely causes vomiting, and has no cumulative action. 

Antidotes. — Emetics, or stomach pump, used promptly ; aconite 
may be indicated. 

Medicinal Uses. — Strophanthus, or strophanthin, has been used 
as a substitute for digitalis, as in mitral regurgitation, when that remedy 
disagrees, or is objectionable from its effect in contracting the arterioles 
and thus throwing more work on an already overtaxed heart. 

Administration. — A tincture (tinctura strophanthi), 5 parts in 100 
of diluted alcohol, is official ; the dose is Tflj-xx, t. d., it may be given 
in tablet triturates. 

Of strophanthin, gr. t&f-ts may be given in granule. 

sparteine. 
Description and Properties. — Sparteine (C 15 H 26 N 2 ) is an alka- 
loid obtained from Cytisus Scoparius, or Broom (Nat. Ord. Le- 
guminosse), and occurs as a strongly alkaline, dense oily, unstable 

* Brit. Med. Journ., Nov. 14th, 1885. 

f Op. cit. ; also Proc. Royal Soc., 1879; Journ. Anat. and Phys., 1872; Brit. Med. 
Journ., Jan. 22d, 1887, and a monograph by Fraser "on the action of the digitalis group," 
containing a reprint of foregoing articles. 

%Med. Digest, Sec. 393; 1, 1872. 

I Bull. Gen. de Therap., Aout 23d, 1888, Lemoine. Ibid., t. 116, p. 69, 1889, Egasse. 



2S4 MATERIA MEDICA AND THERAPEUTICS. 

liquid, but slightly soluble in water, readily soluble in alcohol, and 
having an aniline-like odor. It combines easily with acids to form 
salts, which are preferred for medicinal use because they are more 
readily soluble. Sparteines Sulphas [sparteine sulphate) (C 15 H 26 N 2 H 2 
S0 4 ), is now official. It has a saline, bitter taste, and is very soluble in 
water. 

Aids. — Digitalis, strophanthus, and adonidin. 

Physiological Effects. — Sparteine possesses an intensely bitter 
taste. Like the other members of the digitalis group, sparteine is a 
cardiac tonic, acting through the central nervous system, increasing 
the intensity and persistence of the ventricular contractions and regulat- 
ing the cardiac rhythm.* 

In large doses it completely paralyzes the motor-nerves and 
diminishes reflex action (Fick). It does not appear to affect muscular 
contractility. Sparteine is probably not the diuretic principle of Sco- 
parius, and according to most observers has no effect on the urine, 
although Fick asserts that it increases diuresis. It does not disorder 
the stomach, has no cumulative action, and acts on the heart more 
promptly than digitalis (See). In overdoses it is capable of causing a 
fatal result, death being due to paralysis of the respiratory centre, and 
preceded by a stage of excitement, quickly followed by collapse. 
Poisoning from sparteine should be treated by artificial respiration and 
electricity applied over the vagi ; and if it has been taken by the mouth 
in the form of sulphate, potassic iodide in aqueous solution should be 
administered, as in the presence of water this seems to form an almost 
insoluble salt (Dandrieu), and in any event elimination should be 
favored by diuretics and diluents. 

Medicinal Uses. — It has been used with success in cases of weak, 
irritable and irregular heart, particularly when the cardiac rhythm is 
disturbed. It is employed as a substitute for digitalis in mitral regur- 
gitation, in cardiac dropsy and in cardiac dyspnoea, but that it can fully 
replace digitalis in the treatment of heart-affections is not yet well 
established. As its action is more rapid than digitalis, it may be pre- 
scribed when prompt results are required, and thus gain the time 
necessary for the influence of the digitalis to manifest itself. 

Administration. — The sulphate (sparteine? sulphas) is the salt 



* Archiv. fur experiment. Pathol und Pharmahol., Fick. Band i, p. 397. These, 
Montpellier, 1887 ; "La Sparteine et ses Sels," par P. Dandrieu. Gaz. Hebdom., Nov. 27th, 
1885, Germain See, et al. 



SPINANTS—CIMICIFUGA— BLACK SNAKEROOT. 285 

usually preferred, and may be given in doses of gr. }&-), t. d., in pill, 
capsule, or watery solution. It is also used hypodermically. 

CONVALLARIA-LILLY OF THE VALLEY. 

Description, Habitat and Properties. — The rhizome and 
roots of Convallaria Majalis, found in the Allegheny Mountains from 
Virginia southward. It comes in cylindrical, wrinkled, whitish pieces, 
marked by circular scars ; at the annulate point are found eight or ten 
rootlets. 

Chemical Constituents. — A bitter glucoside, convallamarin 
(C 23 H M 12 ) (Walz*), and an acrid principle, convallarin (C^H^Ou), 
have been isolated. 

Physiological Effects. — Its taste is sweetish, bitter and acrid. 
Within the stomach in full dose it proves emetic and purgative. Upon 
the heart it acts like digitalis. Convallarin gr. ij-iv is purgative, and 
reduces the blood-pressure. Convallamarin is emetic. Under con- 
vallaria some increase in urine has been noted. 

Medicinal Uses. — Valvular heart disease with dropsy, particu- 
larly mitral disease. 

Administration. — Extractum convallarice fluidum, dose, Tftv-xv. 
Of convallamarin, gr. %-)■ 

CIMICIFUGA— BLACK SNAKEROOT. 

Description and Habitat. — Cimicifuga racemosa, or Cohosh 
{Nat. Ord. Ranunculaceae), is a very common indigenous perennial 
plant, growing to the height of from four to eight feet, with ternate 
leaves, oblong-ovate, incised and toothed leaflets, and small white 
flowers disposed in a long raceme. The rhizome and roots are the 
parts employed. 

Properties and Constituents. — The rhizome is a rugged, black- 
ish-brown caudex, from a third of an inch to an inch in thickness, 
often several inches in length, furnished with numerous slender root- 
lets. Internally its color is whitish ; it has a peculiar faint, disagree- 
able odor and an acrid taste. It imparts its virtues to boiling water, 
and contains gum, starch, two resins, tannic and gallic acids, and a 
volatile oil. The active principle has not yet been isolated, nor has a 
crystalline proximate substance been found. f 

. * National Dispensatory, 5th ed. 
f " Lloyd's Drugs and Med. of North America," Vol. I, p. 266. 



286 



MATERIA MEDICA AND THERAPEUTICS. 



pre- 



Incompatibles. — As it contains tannic and gallic acids (q. v. 
cipitates are formed with ferric salts. 

Aids. — Digitalis, strophanthus, and sparteine enhance its cardiac 
action ; ergot, upon the uterus. 

Physiological Effects. — Its taste is bitter; in large doses it 
gives rise to nausea and vomiting. It is undoubtedly an active stim- 
ulant of the secretions, particularly those of the skin, mucous mem- 
branes and kidneys. The effects of cimicifuga are not very accurately 
known. After large doses, vertigo, dilated pupil, and often hypnotic 



fig. 24. 




CIMICIFUGA RACEMOSA. 



and anodyne effects are seen. On the circulation its effects are similar 
to, but less powerful than, those of digitalis, as it slows the cardiac 



SPINANTS—CONIUM. 287 

beat, while increasing the strength of its contraction, and raising the 
arterial tension. It acts on the uterus and unstriped muscles like ergot, 
but less powerfully. It increases the sexual appetite of the male and 
promotes the menstrual flow of the female. 

Medicinal Uses. — It has been prescribed with advantage as an 
expectorant in chronic bronchitis. In fatty heart it is safer than digi- 
talis, and may be used in dilated heart, with languid circulation and 
oppressed breathing. It has also been used as a diaphoretic in rheu- 
matism and as a diuretic in dropsies. As an antispasmodic in chorea it 
enjoys some reputation. In the relief of after-pains, and in Menor- 
rhagia it is frequently of service. 

Administration. — Dose, in powder, gr. xx-5j. Of the fluid ex- 
tract (extractum cimicifugcs fluiduni) or tincture (tmctura cimicifugcz), 
the dose is f 5ss-j or ij ; of the extract {extractum cimicifugce), gr. xx. 
The tincture may be had in tablet triturates. 

DEPRESSO-MOTORS. 

CONIUM— HEMLOCK. 

Description, Habitat and Properties. — Conium maculatum 
(Nat. Ord. Umbelliferaej, is a biennial European plant, naturalized in 
many parts of the United States. Its stem is erect, from three to five 
feet high. The leaves are large and bright-green ; the flowers are 
small, white, and arranged in umbels. The whole plant is narcotic 
and virulent, and has a fetid, heavy odor. The full-grown fruit 
(gathered while yet green, and carefully dried) is the only portion used- 
It has a yellowish-gray color, and a feeble odor ; it is roundish ovate, 
a line and a half in length by a line in breadth, and striated. 

Chemical Constituents and Tests. — The active principle of hem- 
lock is an alkaloid termed conine (C 8 H 15 N), which exists in larger 
proportion in the seed than in the leaves. It is a colorless, trans- 
parent, volatile, oily fluid, of a peculiar repulsive, suffocating, mouse- 
like odor and a bitterish taste, sparingly soluble in water, and freely 
so in alcohol, ether and chloroform, and undergoes decomposition 
upon exposure to the air. It is a highly energetic poison, even in 
very small quantity ; the dose of it is gr. J^. Other alkaloids, termed 
conhydrine (C 8 H 17 NO) and methy leonine (C 8 H 14 CH 3 N), have been 
isolated ; all probably exist as malates. Conine combines with acids 
to form salts, and unites with water as a hydrate. Tests. — Sulphuric 
acid turns conine to purplish-red changing to green ; with perchloride 
of gold a yellowish-white precipitate is formed. 



2SS 



MATERIA MEDICA AND THERAPEUTICS, 



Incompatibles.— Solutions of the alkalies liberate the alkaloid 
from its salts with the odor of hemlock. Tannic acid precipitates the 
alkaloid. 

Aids. — Depresso-motors as woorara, physostigma, tobacco and 
gelsemium. 

Physiological Effects. — The following account is based on the 
investigations of Lautenbach * (chiefly), and Hubert- Valleroux.f 
Local action : conine applied to a part produces paralysis of the end- 
organs of the sensory nerves with which it is brought in contact, and 

Fig. 25. 




CONIUM MACULATUM. 

consequently numbness or loss of sensation. The action of hemlock 
depends for the most part on conine. The taste of the former is 
slightly bitterish. Secretions : conium has no action on the glandular 
organs, except the salivary glands, the discharge from which it in- 
creases. Conine readily diffuses from the stomach into the blood, but 
what action it exerts or changes it there produces are totally unknown. 
Nervous system : hemlock has but little influence upon the cerebral 



* Trans. Acad. Nat. Sci., Phila., 1875, P- 3&7 > The Phys. action of hemlock and its 
alkaloid. 

I Arch. Gen. de Medecine, 6e ser., t. xvi, p. 83. De la cigue at son action phys. et 
therap. 



SPINANTS—CONIUM. 289 

hemispheres, as in cases of poisoning from it, consciousness has been 
preserved to the last. A full medicinal dose induces the following 
effects : a sense of muscular fatigue and feebleness of the legs is felt, 
the eye-lids droop, and vision becomes impaired, accompanied by 
dilatation of the pupil. In lethal doses (ionium causes paralysis, which 
is due to a paralyzing influence on the terminal extremities of the 
motor-nerves. It impairs the conductivity of the sensory nerves, 
while its action on the cord is one of progressive depression (Lauten- 
bach). It has no direct hypJtotic effect. Like woorara, its characteristic 
physiological effect is the production of pure motor paralysis, beginning 
in the extremities and extending to the trunk, involving chiefly the 
terminal nerve-endings. The circulation is at first accelerated, then 
retarded, but further investigation is here required. The arterial pres- 
sure is at first lowered, and then decidedly raised ; the respiratory 
movements are not altered unless a poisonous dose has been taken, 
when the respiratory centre is paralyzed and death ensues from as- 
phyxia. Temperature : some lowering of the animal heat has been 
noted ; but this, lately, has been denied by Lautenbach. Elimination : 
hemlock is eliminated in part by the urine, as it has been found there. 
Orfila detected it in the spleen, kidneys and lungs. 

Toxicology and Antidotes. — In large doses it causes nausea, 
vertigo, dimness of vision, relaxation of the muscles; and in poisonous 
quantities, dilatation of the pupils, difficulty of speech, delirium or coma, 
paralysis, and finally convulsions (of cerebral origin) and death. In 
cases of poisoning, the stomach must be evacuated, and as physiologi- 
cal antidotes, the tetanizing agents, as strychnine and picrotoxin given, 
and alcoholic stimuli if necessary. 

Medicinal Uses. — Conium is quickly absorbed, and is eliminated 
with equal rapidity; hence, its effects are speedily induced and are of 
brief duration. It has been prescribed as an antispasmodic in asthma, 
as a motor-depressant to alleviate paralysis agitans, and in acute mania, 
and as an anodyne in neuralgia ; as an adjuvant to other remedies in 
melancholia; to moderate irritability of the sexual organs ; and to 
relieve the blepharospasm of many acute inflammations of the eye It is 
used topically as an anodyne-cataplasm to cancerous and irritable ulcers. 
It is likewise employed as a general and topical anodyne, to relieve the 
pain of malignant tumors ; and, even if destitute of the deobstruent 
powers which have been ascribed to it, it certainly exerts a palliative 
influence upon painful chronic indurations. 

Administration. — The dose of the powder, gr. ss-j. The extract 
19 



290 MATERIA MEDICA AND THERAPEUTICS. 

(cxtr •actum conii) may be given in the same doses. A fluid extract (ex- 
tractum conii fluiduni) is also used ; of the fluid extract, in preparing 
which acetic acid is employed to fix the alkaloid coiiine, the dose is 
Tftiv-v, gradually increased until some effect is obtained. 

The preparations of conj,um are uncertain, from the fact that the 
active principle is very volatile and easily escapes. Probably the best 
preparation is the fluid extract. 

PHYSOSTIGMA-CALABAR BEAN. 

Description, Habitat and Properties. — Physostigma is the 
seed of Physostigma venenosum {Nat. Ord. Leguminosae), a perennial 
climbing plant of the western coast of Africa. The seed is about the 
size of a large horse-bean, irregularly kidney-form in shape, with a 
hard, brittle integument, and of a dark chocolate-brown color. The 
inner kernel is by far the more active portion. Alcohol, but not water, 
extracts its medicinal virtues. The Calabar bean has long been used 
among the negroes of western Africa as an ordeal to determine the 
guilt or innocence of accused individuals, whence its name, the ordeal 
bean of Calabar. 

Fig. 26. 




CALABAR BEAN. 

Chemical Constituents. — It yields an active alkaloid, termed 
eserine or physostigmine (C 15 H 21 N 3 2 ) sparingly soluble in water, but 
more soluble in alcohol, ether, and chloroform ; and recently another 
alkaloid, termed calabarine, which is believed to be a tetanizing agent, 
has been found in it in variable amount. 

Incompatibles. — The alkalies and tannic acid. 

Aids. — The motor-depressants, as conium, gelsemium, woorara, 
tobacco, etc. 

Physiological Effects. — The /^^/application of a strong solu- 
tion abolishes the functions of both kinds of nerves (Fraser).* 

* For an elaborate account of the action of Calabar bean, consult Dr. T. R. Fraser's 
Thesis, 1863. 



SPINANTS— PHYSOSTIGMA. 291 

An interesting effect of the action of eserine is its remarkable 
power of contracting the pupil, whether taken internally or applied 
externally : it seems probable that this is accomplished by a local 
peripheral action — i. e. t paralysis of the sympathetic terminals and 
stimulation of the oculo-motor fibres in the iris ; and it also contracts 
the ciliary muscle, which regulates the accommodating power of the 
eye. Its myotic strength is feebler than the mydriatic action of the 
pupil-dilators, and the latter soon overcome it. 

Its taste is bean-like, and it augments the salivary flow, as well as 
the secretion of the sweat, mucous and lachrymal glands. Small 
amounts are apt to excite gastric pain and nausea through the excitation 
of intestinal peristalsis. It has been found, in full medicinal doses, to 
produce giddiness, torpor, paleness and coolness of the surface, weak 
and irregular pulse, relaxation of the muscular system, and drowsiness, 
but not stupor. 

Nervous system : the brain is not directly affected by Calabar 
bean, the paralysis induced by it being due to a depressing action upon 
the spinal cord. In proof of this statement can be offered the fact 
that the muscular contractility and irritability of the motor and sensi- 
bility of the sensory nerves, as well as preservation of the mental 
faculties, remain unimpaired in cases of poisoning by physostigma. 
Lethal doses of physostigma cause total loss of reflex activity in the 
cord. Circulation: small doses of physostigma retard the heart's 
action by lengthening the diastolic pause, while toxic doses arrest it in 
diastole, but before the movements are extinguished there is a marked . 
fall in blood-pressure. The stoppage is probably due to paralysis of 
the cardiac ganglia. Respiration: toxic doses of physostigma cause 
slowing of these movements, and eventually they are abolished, death 
ensuing from asphyxia. Involuntary muscles: under its full influence 
the spleen, uterus and bladder become contracted; intestinal peristalsis 
is decidedly excited, it may be to such an extent that the calibre of 
the tube is much narrowed. Calabar bean is allied in its effects to 
woorara and conium, but differs from them in its tendency to produce 
muscular twitchings and contraction of the pupil. 

Toxicology and Antidotes. — A poisonous dose of physostigma 
in man causes nausea, giddiness, muscular weakness and tremors, 
diminished cardiac action, abolition of reflex action, slow respiration, 
myosis and motor-paralysis. Grains 12 of seed* caused stupor and 

* Forensic Medicine, 1883. 



292 MATERIA MEDIC A AND THERAPEUTICS. 

giddiness, the mental faculties remaining intact; recovery. Six of 
the beans killed a child of six years. In cases of poisoning, after 
emptying the stomach, the hypodermic administration of a solution of 
atropine is the best physiological antidote. Chloral mitigates the 
symptoms, and the tetanizers may render service ; artificial respiration 
should be practised. 

Medicinal Uses. — Calabar bean has been found highly efficacious, 
from its power of reducing and abolishing the reflex activity of the 
cord, in traumatic tetanus, but it must be given in doses large enough 
to attain decided effects. Fraser advises the exhibition of eserine 
hypodermically in severe cases. It has been used also as a motor- 
depressant in paralysis agitans ; likewise in poisoning from strychnine. 
The prolonged use of Calabar bean or eserine has occasionally been 
followed by improvement in locomotor ataxia. In ophthalmic surgery 
the employment of eserine is obvious, either to produce contraction of 
the pupil or to increase the power of accommodating the eye to dis- 
tances. Harlan* states that should it fail to narrow the pupil, harm 
may follow by an increased flow of blood to the iris and the ciliary 
spasm which it induces. 

Administration. — The dose of the kernel is laid down as gr. 
ij-iij, to begin with, gradually increased. By exhausting the kernel 
with alcohol, and subsequent evaporation, an extract {extractum physos- 
tigmatis) is obtained, of which the dose is gr. y&. A good form of 
exhibition is the tincture (tinctura physostigmatis), dose Tft v-xv ; or a 
solution in glycerin may be used. Eserine itself, or the sulphate gr. 
ro-j to the ounce, may be applied to the eye in ophthalmic practice, as 
to contract the pupil in photophobia, to lessen intraocular tension early 
in glaucoma and keratitis ; the dose of eserine, internally, is gr. 
gV-tV. Physostigmince salicylas is official. It is the most stable salt of 
the alkaloid, but its slight solubility in water renders it of little value 
for hypodermic injection, dose, gr. ~h-\. PliysostigmincB sulphas, readily 
soluble in water, has been added to the U. S. P. of 1890; dose, gr. 
eV-i. Gelatin-disks of these salts are now much used by oculists. 

CHLORAL. 

This interesting compound, although discovered by Liebig in 
1832, has attracted attention as a therapeutic agent only since the 
statements of Liebreich, a physician of Prussia, published in May, 1869. 

* Handbook of Local Therapeutics, 1893, p. 356. 



SPINA NTS— CHLORAL. 293 

Preparation. — It is prepared by passing dried chlorine gas 
through pure anhydrous alcohol, afterward gently heating, when the 
liquid separates into two layers, the lower of which is chloral. The 
reaction, upon which the formation of chloral depends, in this process, 
is complicated, chloral and hydrochloric acids being the chief products. 
Anhydrous chloral (C 2 HC1 3 0) is a thin, limpid, oily, colorless liquid, 
greasy to the touch, with a fatty taste, and a strong pungent smell, 
producing lachrymation. Chemically, it is classed with the halogen- 
aldehydes. It has a sp. gr. of 1.502, a boiling point of 203 F., and 
mixes in all proportions with water, alcohol, ether and chloroform. 

Chemistry and Tests. — Mixed with one-eighth its weight 
of distilled water, it combines to form the so-called hydrate 
(C 2 HC1 3 0+H 2 0), for it contains an entire molecule of water, which 
crystallizes in a mass of snow-white needles, soluble in their own 
weight of water, slowly volatilizing in the air ; and as pure chloral 
readily undergoes decomposition, the more stable hydrate is the form 
which is employed for medicinal use. Tests. — Pure chloral hydrate* 
when pressed between blotting-paper does not leave oily spots ; its 
taste is bitter, makes a neutral solution with water without forming 
oily drops ; is not decomposed by the action of the atmosphere ; 
dissolves readily in water, ether and alcohol ; the aqueous solution 
acidulated with HN0 3 affords no evidence of chlorine when treated 
with AgN0 3 . The chloroformic solution yields no change of color-, 
when agitated with H 2 S0 4 . 

Incompatibles. — The volatile and fixed alkalies, and calcic 
hydrate, convert chloral into formate of the metal and chloroform. 

Aids. — Morphia, the bromides, and sleep-producing agents 
enhance its hypnotic effects ; upon the spinal cord, conium, physos- 
tigma, woorara, etc. 

Physiological Effects. — Chloral has antiseptic properties, de- 
stroying low organisms and preventing the decomposition which they 
induce, as . pointed out by Keen ; f and it is also an irritant. Its 
taste is bitter, astringent and somewhat caustic. Small doses are 
without obvious effect on the stomach ; large, may be followed by 
nausea and vomiting. It is readily appropriated by the blood, but 
nothing is known as to its action upon this fluid. It was formerly 
asserted by Liebreich that chloral is decomposed by the alkalies in the 

* Attfield's " Chemistry," 10th ed., p. 444. 
f Amer. Journ. Med. Set., July, 1875. 



294 MATERIA MEDICA AND THERAPEUTICS. 

blood with the liberation of chloroform ; but this is not the case, as 
Amory * has proved, for no chloroform could be detected in the breath 
or blood of a dog poisoned by chloral, but on introducing chloroform 
by enemas this drug was found in the blood and respired air at once. 
Nervous system : in doses of 20 grains, chloral is a most reliable 
hypnotic, the sleep being usually quiet, natural, and refreshing.f 
Generally, no unpleasant effects follow its employment, though occa- 
sionally headache and slight nausea supervene. According to Ham- 
mond, chloral causes cerebral anaemia, the brain being in this condition 
when chloral sleep sets in. In medicinal doses, it is not a pain-relieving 
agent in the way that opium is. In hypnotic doses it slightly contracts 
the pupil. 

When larger amounts are given, the sleep is deeper, and may pass 
into coma; the respiration is slower; the pulse is reduced in fullness 
and frequency, the arterial tension being lowered ; the temperature 
falls; the muscular system is relaxed; and both sensibility and reflex 
action are abolished, the latter being brought about by a direct action 
on the spinal cord, since chloral does not affect the motor-nerves nor 
muscular contractility. RingerJ found that it affected the cardiac 
tissues directly and ultimately stopped the heart in diastole, the con- 
tractility of the muscle-substance being extinguished by it, though 
Brunton states it paralyzes the cardiac ganglia. 

Da Costa § states that it has no special action on the secretions, 
except some augmentation of the urine, and is probably eliminated 
by the kidneys. 

Toxicology. — Large amounts may be taken without fatal results, 
as 460 grains have been given without unpleasant effects, though gr. 
xx, in three cases, proved poisonous, and gr. xxx killed an adult 
female. || The symptoms of poisoning are profound sleep, diminished 
frequency of the respiration and circulation, redness of the conjunctivae, 
contraction of the pupils, lividity of the lips, and falling of the jaw, 
with occasional eruptions of the skin. Death takes place probably 
from sudden failure of the heart's action, which stops in diastole, or 
from paralysis of the respiratory centre. 

* N. Y. Med. Journ., xv, 1872, 606; also Journal de P Anatomie et de la Physi- 
ologie, 1870-71, p. 570. 

t Bull. Gen. de The rap., LXXVII, p. 307, Demarquay. 

% Brit. Med. Jour., March 10th, 1883. Experimental investigation on the action of 
chloral, etc. 

\ Am. Jour. Med. Sci., April, 1870, p. 309. Clinical notes on chloral. 

II The Lancet, March 25th, 1 87 1, 403. 



SPINANTS— CHLORAL. 295 

Antidotes. — The treatment of chloral poisoning is much the 
same as that pursued in opium-poisoning; artificial respiration should 
always be resorted to before the respirations cease. Strychnine has been 
recommended to prevent cardiac failure, but according to Dr. Kobert, 
while chloral is the best antidote for poisoning by strychnine, their 
antagonism is not reciprocal, as the latter neither prevents the respira- 
tory arrest, nor counteracts the depressing effect of chloral on the 
heart, nor prevents the lowering of the bodily heat. Atropine is prob- 
ably the best antidote in cases of chloral-poisoning ; it should be given 
frequently, guided by the respiration, and the temperature of the body 
should be maintained by the application of dry heat in the form of hot 
blankets and bottles, Lauder Brunton having pointed out that animals 
when thus kept warm, survived toxic doses. 

Medicinal Uses. — Chloral is a most valuable hypnotic remedy in 
all the forms of insomnia, in hysterical excitement, in acute mania, 
mania d potu, and in delirium tremens. As an antispasmodic, large 
doses are required. It has been used with advantage in infantile 
convulsions, and even in puerperal and urcemic convulsions, both by the 
mouth and hypodermically, and it is especially recommended in the 
relief of rigid os during labor. In sea-sickness it is highly recom- 
mended, though nothing is of much service in this complaint. In 
tetanus, in order to lessen the spinal reflex activity, much success has 
been obtained with chloral, in ten-grain doses every two hours ; and 
the same remedy may be given to alleviate the paroxysms of spasm 
of rabies. In whooping-cough it has also been employed with advan- 
tage, and as an antidote against strychnine. As an anodyne it is 
available, but only in narcotic amounts. Topically, in dilution (gr. x 
to f§j of water), or as an ointment (5ss to Sj), it is a good stimulant 
and deodorizing application to foul and fetid indolent ulcers ; as an 
injection in gonorrhoea (gr. xx to f§j of water), it answers well ; and 
injected into subjects for the dissecting-room (Keen, loc. cit.), and in 
the preservation of anatomical preparations, it has been also found 
useful (gr. xl to f§j of water). 

Administration. — The ordinary dose of chloral is 20 grains, 
which may be safely repeated every hour or two, till three doses have 
been taken or sleep occurs. An equal weight of chloral hydrate, 
added to powdered camphor, makes a valuable local rubefacient liquid. 
Chloral is given only in aqueous solution, and the addition of aromatic 
elixir or syrup, particularly the syrup of orange-peel, will disguise 
its unpleasant taste ; thus, Ify Chloral hydrate, f5ij ; syr. aurantii 



296 MATERIA MEDICA AND THERAPEUTICS. 

riorum, fgij. M. S. fo}4, as required. It is not well adapted to the 
hypodermic method, as painful phlegmons sometimes follow its 
repeated use. It should be kept in glass-stoppered vials. 

POTASSII BROMIDUM— POTASSIUM BROMIDE. 

Preparation and Test. — Potassium bromide (KBr) is prepared 
by adding a solution of pure potassium carbonate to a solution of fer- 
rous bromide. The iron is precipitated, and the potassium bromide 
remains in solution, from which it is obtained by evaporation. It 
occurs as a permanent, colorless, anhydrous, crystalline salt, of a pun- 
gent, saline taste, very soluble in water, and slightly so in alcohol. 
When mixed with starch, a yellow color is developed on the addition 
of chlorine. A bluish tint shows the presence of an iodide. 

Incompatibles. — Acids, acidulous and metallic salts decompose 
potassium bromide ; with calomel an interchange of bases takes place ; 
with the alkaloids bromides are formed. 

Aids. — Its action on the brain is enhanced by morphia, chloral, 
paraldehyde and similar agents; its depressing effects on the circula- 
tion by aconite, gelsemium, veratrum viride, etc. 

Physiological Effects. — The statement of the action of potas- 
sium bromide is based on the investigations of Amory,* Bill,f Nu- 
neley,^ Bartholow,§ Lasegue,|| Damourette et Pelvet.^f Local action : 
when applied to the pharyngeal mucous membrane, it is said to lessen 
the reflex irritability of the part. When brought in contact with the 
motor-nerves and spinal centres of the frog, potassium bromide 
destroys their functions. This action, however, is probably due to the 
potassium which it contains (Ringer), and is shared by the other 
potassium salts. 

When administered internally (to animals), the irritability of the 
brain is decreased, owing in great part to the anaemia caused by the 
action of the drug upon the vaso-motor nerves which govern the 
calibre of the vessels. Reflex irritability is diminished, partly on 
account of the paralyzing influence exerted on the reflex functions of 
the cord, and in part from paralysis of the end-organs of the peripheral 

* Pamphlet, 1869. " Exper. upon the Phys. Action of Bromide of Potassium, etc." 
•\ Am. J. Med. Set., July, 1868. 
{ The Practitioner, III, 347. 

\ Pamphlet, 16 pp. "Exp. Investigation into the Actions and Uses of the Bromide of 
Potassium." 

|| Arch, Gen. de Medicine, t. VI., 6ieme ser., p. 81. 
\ Bull. Gen. de Therap., lxxiii, pp. 241, 289. 



SPINANTS— POTASSIUM BROMIDE. 297 

nerves ; on the latter account, also, cutaneous sensibility is lessened. 
It possesses a sedative action on the sympathetic system, giving rise 
to diminished cardiac action, decrease in the supply of blood to various 
organs, and slight reduction in the temperature of the body. 

Circulation : topically applied to the heart (and voluntary muscles), 
it destroys their functions, as in the case of the topical application to 
the nervous centres, and probably for the same reason. In ve^ large 
doses it lessens the frequency and force of the cardiac contractions, 
shortening the systole, prolonging the diastole, and, finally, paralyzing 
the heart in diastole. The tension of the arterial system is lowered. 
Respiration : it slows respiration and causes death by arrest of the res- 
piratory centres (Ott). Temperature : in warm-blooded animals, toxic 
doses lower very decidedly the temperature, probably owing to a direct 
checking of tissue-changes. Secretion : at first the secretions and ex- 
cretions are diminished, but, later, they are increased in amount. If a 
very large dose is taken, they are increased primarily. No lachryma- 
tion, salivation, or catarrh is produced, as after the administration of 
the iodides. After large doses, micturition is less frequent, because 
the vesical irritability is lessened, — not because the amount of urine is 
decreased. A very large dose may paralyze the sphincter and produce 
incontinence of urine. The amount of urea eliminated is diminished, 
as is, also, the quantity of carbonic acid exhaled from the lungs, and 
the perspiration is decreased. 

In man, the action of the bromides is similar to the action in ani- 
mals; the cerebral symptoms being, however, more marked, because 
of the greater development of the hemispheres. Their taste is saline 
and disagreeable. They lessen the activity of the brain, suppress the 
emotions, and mental irritability, thus bringing the individual into a 
condition favorable to sleep. And, being almost without depressing 
after-effects, they are most valuable hypnotics. When long continued, 
potassium bromide exerts a very marked depressing effect upon the 
sexual functions, enfeebling their vigor, and diminishing the sexual 
appetite. But these symptoms pass away when the drug is withheld. 
When considerable doses are given for a long period, a train of symp- 
toms is produced to which the name bromism is applied. These are 
mental weakness, great drowsiness, failure of memory, anaemia, malnu- 
trition and depression of spirits, with often, impaired sensibility of the 
mucous and cutanous surfaces, diminution of the sexual functions, and 
an eruption of the skin (generally on the face and back), usually of 
acne, which rarely suppurates, occasionally of eczema, and, very rarely, 



298 MATERIA MEDICA AND THERAPEUTICS. 

rupial ulcers may be seen. Elimination : potassium bromide is elimi- 
nated chiefly by the kidneys ; but also by the mucous membranes of 
the fauces, intestinal canal and bronchi, by the skin, and by the salivary 
glands. It is absorbed by the blood rapidly (Bartholow, loc. cit.) as 
traces may be found in the urine ten minutes after its administration,* 
but elimination is slow. According to Amory {loc. cit.), it passes out, 
when given in medicinal doses, undecomposed, by the skin and kidneys. 
No case of acute poisoning by potassium bromide has been reported. 

Medicinal Uses. — From its action on the nervous system, potas- 
sium bromide is much used to quiet cerebral excitement and for its 
sedative effect on the reflex centres of the cord. And for this purpose 
it is of great value in meningitis, cerebral or spinal, to allay irritation 
and hinder convulsions. 

As a narcotic (by causing anaemia of the brain), it is much used 
in insomnia due to cerebral hyperemia, or even when not more than 
the normal amount of blood is sent to the brain ; in wakefulness and 
wandering during convalescence from acute diseases ; and in sleep- 
lessness due to worry, grief, dyspepsia, and over-work. In cases of 
night-horror, in children, where they awake suddenly and scream with 
fright, (often for a considerable time), small doses of this salt and a light 
supper will frequently effect a cure. Adults subject to nightmare will 
find relief, too, in the temporary use of potassium bromide. To allay 
restlessness, remove delusions, calm delirium, and produce sleep in the 
early stages of delirium tremens and in mania ct potu, it is given in 
doses of gr. xx to xxx every two hours until sleep is produced. It is 
more efficient in the early stages, and can be relied on with more cer- 
tainty in the first than in subsequent attacks. 

For the relief of uncomplicated vertigo it is of service, and it is 
one of the remedies used for laryngismus stridulus, and during the 
paroxysmal stage of whooping-cough. It may be prescribed also to 
stop obstinate hiccough a.nd spasmodic pharyngeal cough, particularly at 
night. 

In those functional cardiac affections in which excited or irregular 
action is a prominent symptom, as irritable or over-acting heart, or in 
palpitation, the bromides by lessening the frequency and force of the 
contractions, render important service. In the last two conditions 
aconite is a valuable adjuvant. 

Potassium bromide is often combined with other narcotics, as 

*Clinique Therapeutique, iii, p. 202, note (2), Dujardin-Beaumetz. 



SPINANTS— POTASSIUM BROMIDE 299 

morphia, chloral, etc., to aid their action, and even to modify their disa- 
greeable effects. It will generally prove beneficial in women suffering 
from nervousness, great despondency, amounting to a feeling of ap- 
proaching madness, irritability, lack of interest in their surround- 
ings, sleeplessness and harassing dreams, caused by overwork, want 
of change, grief or worry. If the medicine does not succeed alone, it 
will when combined with a change of scene. In some cases of hysteria, 
potassium bromide is a valuable remedy. In all forms of convulsions 
(epilepsy, chorea, convulsions of chronic Bright s disease, convulsions of 
children, etc.) it will prove beneficial, by diminishing the reflex function 
of the cord. 

In epilepsy the bromides are preeminently of service, lessening the 
frequency of the attacks, if not absolutely, in some cases at least, pre- 
venting their recurrence. In certain cases after continual use they 
lose their efficiency ; in others they fail altogether. It must be borne 
in mind, too, that little or no benefit is to be obtajned from them, if 
the cause be due to cranial deformity, to hereditary tuberculosis, men- 
struation and the like. It is stated by Trousseau that they are less 
efficient in attacks of petit mal than in those of severer form ; but Dr. 
A. Hughes Bennett has recently published a number of cases of the 
lighter variety, in the majority of which the bromides proved success- 
ful. They should be given in doses sufficient to prevent reflex retch- 
ing or nausea, when the fauces are tickled (Voisin), and must be con- 
tinued for years (2-3), with an occasional intermission of a week or 
two. At the same time the propriety of stopping the drug when 
bromism-symptoms appear must not be lost sight of. In nocturnal 
epilepsy 'Si will be required 2 hours before bed-time ; attacks that set in 
at the time of getting up are best prevented by taking a large dose on 
wakening. For epileptics in general, Seguin advises the administra- 
tion of a single daily dose, 4 to 6 hours before the expected attack. 
The diet should be vegetarian and milk. 

Potassium bromide has been successfully used in the treatment 
of strychnine -poisoning ; it should be given in doses of 5ij, frequently 
repeated, as the case may require. It has also been successfully used 
in tetanus. It has been recommended during dentition, to allay irrita- 
bility and restlessness and to prevent convulsions. It is administered 
for the relief of the convulsions of urcemia, and the puerperal state. In 
the reflex forms of vomiting, as the vomiting of pregnancy, of sea-sick- 
ness, and in migraine or sick headache (especially in the congestive 
forms), it is sometimes beneficial. In the colic of infants, unaccom- 



300 MATERIA MEDICA AND THERAPEUTICS. 

panied by diarrhoea, it is an excellent remedy, relieving pain and spasm, 
and producing sleep. It is used, too, in large doses, 5j or more, to 
obtund the sensibility of the fauces, before the exhibition of the 
laryngoscope, but this is going out of fashion since the introduction 
of cocaine. 

From its sedative influence on the organs of generation, it is 
used with success in nymphomania, spermatorrhoea, masturbation, and 
chordee. In the last affection it may be taken in large doses through- 
out the day, the final one before retiring. It decreases the flow of 
blood in Menorrhagia. The flushes of heat, followed by sweating and 
prostration, occurring at the menopause, are generally cured by the use 
of potassium bromide. 

Administration. — Dose, gr. v-5j or more. In epilepsy it is 
given in doses of gr. xx-xxx, thrice daily, and continued for a long 
period, with occasional intervals of a week or two. Children generally 
tolerate the bromides well and stand large doses. If bromism occur, 
stop the remedy for the time, and give tonics. The bromide rashes 
are easily cured by withdrawing the medicine, and giving liquor 
potassii arsenitis internally in small doses, and the local use of an oint- 
ment containing iodide of sulphur. Potassium bromide is best admin- 
istered in solution, and preferably one hour after meals. It may be 
disguised with aromatic elixir, or in milk diluted with water, apollin- 
aris, or vichy water. It can be had in 5 and 10 grain compressed 
pills. 

AMMONII BROMIDUM-AMMONIUM BROMIDE 

Preparation. — Ammonium bromide (NH 4 Br) is prepared by 
mixing bromine with iron-wire in distilled water, agitating the mixture 
until the liquid assumes a greenish color, and then adding water of 
ammonia to the mixture, which precipitates the iron as ferrous hydrate, 
ammonium bromide remaining in solution. By filtration and evapor- 
ation, a white, granular salt is obtained, which, on exposure to the 
air, gradually becomes yellowish (in consequence of the liberation of 
hydrobromic acid), has a saline, pungent taste, is very soluble in water, 
and moderately so in alcohol. 

Incompatibles and Aids. — See potassium bromide. 

Physiological Effects. — The action of ammonium bromide re- 
sembles, in many respects, that of the potassium salt. When applied 
locally to the motor nerves, spinal centres, heart, or voluntary muscles, 
it does not destroy their functions, and has less influence, when admin- 
istered internally, on the circulation, respiration and temperature. 



SPINA NTS— AMMONIUM BROMIDE. 301 

Medicinal Uses. — It has been used for the same conditions in 
which potassium bromide is given. Echeverrhia prefers the ammo- 
nium bromide in epileptic maniacal excitement, but states that it will 
fail unless combined with chloral, cannabis Indica, or other narcotic, 
or better still, with ergot. The combined use of ammonium and 
potassium bromide has been recommended by Brown-Sequard. Da 
Costa highly recommends its use in acute rheumatism. It has also 
been given with advantage in whooping-cough. 

Administration. — It is given in doses of gr. v-xxx, thrice daily, 
and is best administered in some bitter effusion, or aromatic elixir. 

Sodii Bromidum {Sodium Bromide} (NaBr) may be prepared in a 
similar manner to potassium bromide. 

In its physiological effects it resembles potassium bromide, but is 
much feebler. 

It is used in the same diseases and in the same doses as is the 
potassium salt. 

Lithii Bromidum {Lithium Bromide) (LiBr) has been recommended 
as the most efficacious of the bromides. S. Weir Mitchell has found 
it efficient in gr. x-xx doses, in some cases of epilepsy, after the potas- 
sium bromide had failed. It has been used in gout, but not with much 
success. It contains a larger per cent, of bromine than do the other 
salts, and is very soluble. 

Calcii Bromidum {Calcium Bromide} (CaBr 2 ) very soluble in water, 
has been employed for the same purposes and in the same doses as 
potassium bromide. 

Zinci Bromidum {Zinc Bromide) (ZnBr 2 ) has been prescribed in the 
treatment of epilepsy, but its use is not general. Hammond* has 
obtained beneficial results with the salt in arresting the epileptic par- 
oxysms where the other bromides had failed, and it has the advantage 
of not causing bromism or a cutaneous eruption. Dose, gr. ij-xx, in 
syrup and water. 

Strontii Bromidum {Strontium Bromide} (SrBr 2 +6H 2 0) has been 
introduced into the U. S. P. of 1890. It is stated not to cause the bromide 
eruptions, or disorder of the stomach; recommended in gastrodynia 
and epilepsy. Dose, gr. x-xxx, in syrup and water; it is deliquescent. 

Acidum Hydrobromicum Dilutum {Diluted Hydrobromic Acid} is a 
clear, colorless liquid, without odor, but having a strongly acid taste, 
which consists of 10 per cent, of absolute hydrobromic acid (HBr), 
and 90 per cent, of water. It has a sp. gr. of 1.077. 

* " A Treatise on Diseases of the Nervous System." 1888, p. 716. 



302 



MATERIA MEDICA AND THERAPEUTICS. 



Effects and Uses. — This acid does not differ materially in its 
action from potassium bromide, and has been used as a substitute for it 
in epilepsy, alcoholism, congestive headache, vertigo, chorea, insomnia, etc. 
It has been recommended to combine it with quinine as a preventive 
of cinchonism. Its value does not seem to be very firmly established. 
Dose of the diluted acid, f5ss-ij. It should be protected from light, 
and kept in glass-stoppered vials. 

TABACUM— TOBACCO. 

Description, Habitat and Properties. — Nicotiana Tabacum, or 
Virginia Tobacco {Nat. Ord. Solanaceae), is a native of the warm 

Fig. 27. 




TOBACCO. 



SPINA NTS— TOBA CCO. 303 

countries of America. It is an annual plant, growing to the height of 
from three to six feet, with large oblong, pointed, hairy, pale-green 
leaves, and light-greenish, funnel-shaped flowers. The dried leaves 
are the portion used. They have a yellowish-brown color, a strong, 
peculiar, narcotic odor, and a bitter taste. The darker-colored leaves 
are the strongest. 

Chemical Constituents and Test. — The virtues of tobacco are 
imparted to alcohol and water, and depend on the presence of an 
alkaloid called nicotine (C 10 H 14 N 2 ) (as a malate), which is found in all 
parts of the plant, but not in tobacco-smoke. It is a colorless, oily, 
volatilizable, alkaline liquid, highly soluble in water, alcohol, ether, 
chloroform, the fixed oils, and oil of turpentine, of a feeble odor when 
cold, but irritant when heated, of an acrid, burning taste, and is a most 
energetic poison, ranking after prussic acid. From the dried leaves 
are also obtained a concrete volatile oil, termed nicotianin, which is 
probably the odorous principle of the plant, and an empyreumatic oil, 
which gives the peculiar smell to old tobacco-pipes. Both of these 
principles are poisonous. Tobacco-smoke* has been found "to con- 
tain numerous basic substances of the picolinic series, and ceded to 
caustic potash, hydrocyanic acid, sulphuretted hydrogen," with fatty 
acids, phenol and creasote. Test. — Nicotine is thrown down from aque- 
ous solution as a yellowish-white precipitate by platinum perchloride. 

Incompatibles. — Tannic acid and the caustic alkalies. 

Aids. — The depresso-motors, as physostigma, woorara, etc. 

Physiological Effects. — Tobacco smoke restrains the develop- 
ment of bacteria (Tassinari). Locally : applied to the skin tobacco is 
readily absorbed ; snuff is an errhine. The taste of tobacco is bitter 
and nauseous, and when chewed it excites the flow of saliva. On 
persons unaccustomed to its use tobacco either smoked, chewed or 
swallowed, produces nausea, depression, and a feeling of wretched- 
ness. Nervous system : tobacco expends its action on the spinal 
cord, and not upon the brain, and nicotine, in full doses, acts as a 
tetanizing agent on man. Nicotine contracts the pupil either locally 
or internally. The conductivity of the motor nerves is more or less 
abolished, and lastly that of the spinal cord, while the voluntary 
muscles remain unaffected. These remarks apply to lethal doses of 
the drug. Circulation : the red globules of the blood of a person 
under the influence of tobacco present a crenated appearance. 

* " Pharmacographia," 2d ed., p. 468. 



304 MATERIA MEDICA AND THERAPEUTICS. 

Tobacco is not a cardiac poison, since the application of nicotine to 
the cut-out heart will not stop its beats ; nevertheless it slows the 
cardiac action and temporarily reduces the blood-pressure. Intestines : 
tobacco has a relaxing influence upon this tract, and the injection of 
nicotine induces intestinal peristalsis. Nicotine is probably eliminated 
by the kidneys. 

The habitual use of tobacco-smoke as an exhilarant is well 
known. When taken in excess, it frequently develops maladies of 
the stomach, heart, nervous system, and upper air-passages. Under 
its immoderate use such cardiac phenomena as over-action and palpi- 
tation are likely to ensue, and the use of tobacco is contraindicated 
when these conditions exist. Tobacco smoking is least injurious 
when not inhaled. The habitual smoking of tobacco in excess im- 
pairs the sight. 

Toxicology and Antidotes. — In lethal doses, it induces vomit- 
ing and purging, a sensation of sinking at the pit of the stomach, 
giddiness, disorder of vision, contraction of the pupils, depression of 
the circulation, great relaxation of the muscular system, coldness of 
the surface, and other symptoms of prostration ; and, when excessive 
doses have been taken, these symptoms become more violent, and are 
followed by clonic convulsions, paralysis and death. Woodman and 
Tidy * have collected a number of fatal cases from the use of the 
infusion of tobacco by clyster and injection, so that it is a remedy, 
even locally, to be employed with caution. Cases of poisoning are to 
be treated with the diffusible stimuli, after washing out the stomach, 
and strychnine is to be used hypodermically ; dry heat should also 
be applied, and, if these means fail, artificial respiration should be 
resorted to. 

Medicinal Uses. — Tobacco is now rarely used medicinally, and 
if so it is to be employed with caution, as it occasionally acts with 
dangerous energy. A cigar or pipe after breakfast often relieves con- 
stipation. 

Administration. — Tobacco is not given by the stomach, owing 
to its emetic properties. It is usually administered by the rectum, in 
the form of infusion. It may also be smoked for medicinal effect. 

lobelia. 
Description, Habitat and Official Portion. — Lobelia inflata, 
or Indian tobacco (Nat. Ord. Lobeliacese), is a very common annual 

* " Foiensic Medicine, etc.," 1882, p. 381. 



SPINA NTS— LOBELIA. 305 

or biennial indigenous plant, growing to the height of from six inches 
to two feet, having an erect, hairy stem, ovate, serrated leaves, pale- 
blue flowers, and ovoid, inflated capsules. All parts of it are active, 
but the leaves and tops only are official, collected after a portion of 
the capsules is inflated. 

Chemical Constituents. — Water and alcohol extract the virtues 
of lobelia, which contains a partly volatile alkaloid, lobeline, lobelic acid, 
fixed and volatile oil, gum, chlorophyll, etc. Lloyd * regards the alka- 
loid as a fixed one ; he also isolated a substance termed inflatin. 
Lobeline is a yellowish syrupy liquid of an aromatic odor, and an 
acrid taste. 

Incompatibles. — The caustic alkalies decompose lobeline. 

Aids. — The depresso-motors. 

Physiological Effects. — Its taste is at first mild, then burning 
and acrid. Lobelia produces effects on the system analogous to those 
of tobacco, acting in small doses as a sedative, nauseant and diaphoretic. 
In large doses it is an energetic emetic. According to Ott'sf investi- 
gations the alkaloid produced in the rabbit curious alterations of blood- 
pressure, viz. : first a fall, followed generally by a rise, and lastly a very 
decided fall; also slower respiration, paralysis, reduction of tempera- 
ture, and death from asphyxia. Lobelia, like tobacco, retards the 
heart's action, is said to increase the urinary flow, and, in an unex- 
plained way, relieves bronchial spasm. Complete investigations of its 
action have not yet been made. It was employed by the aborigines, 
and has always been a popular empirical remedy. 

Toxicology and Antidotes. — There are on record numerous 
cases of death from lethal amounts of lobelia, 5i of the powdered leaves % 
having in thirty-six hours destroyed life. In poisonous doses it proves 
fatal by paralyzing the respiratory centre in the medulla oblongata, the 
pupil being contracted. The peculiar depressing effects excited by 
lobelia upon the circulatory apparatus may be counteracted in a 
measure by the cardiac excitants as ether, alcohol, ammonia and 
strychnia/ 

Medicinal Uses. — Lobelia is sometimes classed among emetics, 
but its action in this particular is too violent for its safe administration. 
It is chiefly employed by regular practitioners, in virtue of its bronchial 
antispasmodic properties, for the relief of asthma, angi?ia pectoris, and 

* " Drugs and Medicines of North America," Vol. II, p. 75. 
f Boston Med. and Surg, your., 1875. 
X Reese, Med. Jurisprudence, etc., 1889. 
20 



306 



MATERIA ME DIC A AND THERAPEUTICS. 



cardiac dyspnoea, and it is given in small doses, gradually increased 
until headache or nausea ensues. In asthma, Ringer advises lobelia to 
be given in large doses, viz., f5j of the tincture every hour, or even 
every half hour. The chief draw-back to its use is its uncertainty and 
the nausea and depression induced by it. In asthma it possesses no 

Fig. 28. 




LOBELIA INFLATA. 



curative power, seeming to be beneficial by reason of its antispasmodic 
and expectorant properties. It may also be used as an enema, to fulfill 
the same indications as tobacco. 

Administration. — The dose of the powder as an antispasmodic 
is gr. j-iij ; as an emetic, gr. v-xx. The best form, particularly in 
asthma, is the tincture (tinctura lobelicz) (20 per cent., in diluted alcohol), 



SPINA NTS— DILUTED HYDROCYANIC ACID. 307 

which may be given in the quantity of f5ss-j, to be repeated as occa- 
sion may require. A fluid extract (extr -actum lobelia fluidum) is also 
official; dose, Tftj-xxx. Aromatic elixir disguises it, or it can be had 
in compressed triturates. 

ACIDUM HYDROCYANICUM DILUTUM— DILUTED HYDROCYANIC ACID. 

Source and Preparation. — Hydrocyanic acid, known also as 
cyanhydric acid and prussic acid, is derived from a variety of vegetable 
substances, as the bitter almond, peach-kernels and leaves, wild-cherry, 
cherry-laurel, etc. It is employed in medicine only in a state of ex- 
treme dilution ; and the diluted acid is obtained by the action of sul- 
phuric acid and water on potassium ferrocyanide, or when wanted for 
immediate use, by the action of hydrochloric acid and water on silver 
cyanide. 

Chemistry and Tests. — Diluted hydrocyanic acid is a colorless 
volatile liquid, with a peculiar odor and a cooling, somewhat irritating 
taste. It undergoes decomposition if exposed to the light, and should 
be kept in bottles covered with black paint or paper ; but it is not a 
stable preparation. It contains two per cent, of the anhydrous or con- 
centrated acid. 

The anhydrous acid (HCy or HNC) is a colorless, feebly acid, 
transparent, very volatile and decomposable liquid, with a powerful, 
peculiar odor, and a cooling, afterward burning taste. Both water 
and alcohol dissolve it readily. Tests. — Its presence in a suspected 
mixture may be detected by the addition of a solution of silver nitrate, 
which throws down a white, curdy precipitate of silver cyanide, distin- 
guishable by its giving off, when dried and heated in a test tube, 
cyanogen gas which burns with a rose-colored flame (the silver test is 
the most delicate, when applied to prussic acid in the state of vapor) ; 
or, by adding to the suspected solution a little liquor potassse, and 
then a mixed solution of ferrous and ferric sulphate, a dirty greenish- 
blue precipitate is thrown down, which, on the addition of a few drops 
of pure hydrochloric acid becomes Prussian blue (the best liquid test). 

Incompatibles. — The metallic salts. 

Physiological Effects. — The action of the dilute only is con- 
sidered. Locally : hydrocyanic acid applied directly to the skin exerts 
a benumbing influence, and may be absorbed with the aid of friction ; 
to a mucous membrane it is readily taken up, producing poisonous 
effects. It has bactericidal properties. The taste of the acid is almond- 
like ; within the stomach it is sedative. Nervous system : in small 



308 MATERIA MEDICA AND THERAPEUTICS. 

doses it produces no symptoms beyond a calming effect. Full doses 
cause giddiness, confusion of mind, and muscular feebleness. Whether 
large doses act on brain, vagus, or peripheral nerves is disputed. The 
convulsions which it produces are cerebral, for they do not occur in 
parts cut off from the cord. In the frog, Kolliker * finds that the direct 
application of hydrocyanic acid paralyzes the motor-nerve trunks, and 
destroys the irritability of muscle, and upon the peripheral sensory 
nerves acts as a paralyzant. 

Since hydrocyanic acid produces asphyxia most rapidly in the 
form of vapor, Preyer concludes that it acts directly on the pulmonary 
ends of the vagi. That it acts directly on the nerve-centres is sup- 
ported by the experiment of Jones,f in which the application of the 
acid to the medulla of an alligator caused quickly collapse of the lung. 
Circulation : in small doses it has a sedative action on the heart; large 
doses arrest it in diastole (Lecorche et MeuriotJ). When applied 
directly to the heart it suspends the movements. Under hydrocyanic 
acid atemporary increase of the arterial pressure, followed by a reduc- 
tion, has been observed. But this is not in accordance with Lecorche 
and Meuriot's (loc. cit.) investigations. It is only in lethal doses that 
opinion is unanimous as to a decided reduction of blood-pressure. 
Opinions as to the action of hydrocyanic acid on the blood are con- 
tradictory. During life, under hydrocyanic acid, the venous blood is 
found to have an arterial hue; while in man and mammals, after death 
this fluid is dark-colored, probably from deficient abstraction of carbon 
dioxide. Outside of the economy the addition of hydrocyanic acid to 
the blood produces a new body, formed from HCy and haemoglobin, 
called cyanohaemoglobin (Hoppe-Seyler §), which has no ozonizing 
power, and it seems probable that the formation of this substance, if it 
take place during life, in the blood, may be one of the main factors in 
causing death. 

Respiration: nothing short of 10-15 minims disturbs this act, 
this amount rendering it labored and irregular. Large doses destroy 
life so quickly that the respirations cannot be counted. Hydrocyanic 
acid has no influence on temperature, or secretion, save a slight aug- 



* Arch, filr Pathol. Anat., Bd. x, p. 272. 

| N. Y. Med. Record, II, 1867, 456.. 

\ Arch. Gen. de Medecine, 6 ser., xi, p. 529. Etude Phys. et Therap. sur Facide 
cyanhydrique. 

\ Virchovfs Archives, XXXVIII, p. 435. "Ueber die Ursache der Giftigkeit der 
Blausaure." 



SPINA NTS— DILUTED HYDROCYANIC ACID. 309 

mentation of the saliva. Elimination is rapid, taking place by the 
saliva, kidneys and lungs. 

Toxicology.— In a poisonous dose, hydrocyanic acid arrests life 
with fearful rapidity, and it is one of the most energetic poisons known, 
one or two drops of the pure acid being sufficient to destroy a dog in 
a few seconds, and gr. to * of the anhydrous acid killed an adult in 
twenty minutes. When not immediately fatal, it produces great and 
sudden prostration, difficult and spasmodic respiration, dilatation and 
immobility, and sometimes contraction of the pupils, feeble pulse, 
diminution of temperature in the extremities, rise in the trunk at first, 
but followed by a fall, and involuntary evacuations. It acts on both 
the voluntary and involuntary muscles, decreasing or arresting entirely 
their property of contractility; both the sympathetic and cerebro-spinal 
nervous systems appear to be affected. 

Antidotes. — The best antidotes are inhalations of ammonia or its 
carbonate, and (if the patient can swallow) alcoholic stimuli are to be 
employed, and at the same time cold and hot affusions and artificial 
respiration must also be resorted to. The subcutaneous injection of 
atropine sulphate has been proposed as a physiological antidote, but 
its rate of diffusion is too slow to be of service, while Boehm \ states 
that it is not antagonistic at all. 

Medicinal Uses. — Dilute hydrocyanic acid is an agent of some 
value in allaying spasm, pain and nervous irritability, in a variety of 
disorders, and is much used to relieve cough, particularly in phthisis 
pulmonalis, and for its antispasmodic virtues in asthma and whooping- 
cough. It is moreover an efficacious remedy in gastrodynia and in 
neuralgic affections of the bowels, and also in chronic vomiting. Topi- 
cally, it is occasionally employed as an anodyne in neuralgia, and in 
various forms of cutaneous disease (f5j-iij to water Oj-iss), notably 
urticaria and prurigo, as an antipruritic lotion. 

Administration. — The dose of the official acid (acidum hydrocy- 
anicum dilutiun) is gtt. i-ij, given in syrup and water, to be repeated 
and gradually increased by a drop till some effect is perceptible. 
When it is taken for a length of time, care should be observed to have 
the medicine, as renewed, of uniform strength ; and it is best, in using 
a fresh sample, to return to the minimum dose. An approved formula 
to relieve bronchial cough is: ^ Acidi hydrocyanici diluti, TTL30; 

* '' Taylor's Med. Jurisprudence," 3d Am. ed., 142. 
^Practitioner, XIII. p. 168. 



310 MATERIA MEDICA AND THERAPEUTICS. 

syrup, ipecacuanhas, foij ; morphinae sulphatis, gr. iij ; syrup, pruni 
virginiane, ad fSiv. M. S. Dose, teaspoonful every 3 hours. 

Potassii Cyanidum (Potassium Cyanide, KCN), is used as a substi- 
tute for hydrocyanic acid, and has the advantage of being a more uni- 
form chemical product, and less liable to undergo decomposition. 

Properties. — It occurs in white, opaque, amorphous pieces, 
having a sharp, somewhat alkaline and bitter-almond taste, and an 
alkaline reaction ; its solution yields the odor of hydrocyanic acid 
when exposed to the air. It is deliquescent, very soluble in water, 
and sparingly so in alcohol. 

Effects and Uses. — It is irritant and will produce an eschar, 
and is antiseptic in the proportion of 1 to 909 (Miquel). 

Toxicology. — As much as gr. iij have been taken by an adult 
without fatal result (Taylor).* Grains 15 have destroyed life in 15 
minutes, and 7, in less than one hour. Ordinarily gr. i]-i]}4 should 
prove fatal, f Its medicinal and poisonous effects are the same as those 
of hydrocyanic acid. 

Administration. — Dose, gr. y& in f §ss of distilled water, to be 
repeated and increased. 

Oleum Amygdalae Amarae [Oil of Bitter Almond) contains hydrocy- 
anic acid, and may be used for the same purposes. It is obtained by 
distillation from the kernel of the fruit of Amygdalus communis, 
variety Amara (Nat. Ord. Rosaceae), and is of a yellowish color, with 
a bitter, acrid, burning taste, and the peculiar odor of the bitter 
almond, which is different from that of hydrocyanic acid. It is 
heavier than water, slightly soluble in it, and soluble in alcohol and 
ether. 

Chemical Constituents. — It contains benzoic aldehyde and hydro- 
cyanic acid, which are developed from a principle termed amygdalitis 
and water, under the influence of an albuminous ferment termed 
emulsin : thus amygdalin (C^H^NOn) + water (2H 2 0) = benzoic 
aldehyde (C 6 H— COH) + HCN + glucose (2C 6 H 12 6 ). 

Effects and Uses. — The action of this oil upon the system is 
closely analogous to that of hydrocyanic acid, and its strength is 
about four times that of the diluted official acid. 

Administration. — Dose, for internal use, gtt. %—}& in emulsion; 
as an external application, gtt. j to a f 5j of menstruum. Bitter Almond 

* Guy's Hosp. Reports, XIII, 1868. 
| Wharton and Stille,*2,«i884. 



SPINA NTS— A MYL NITRITE. 311 

Water [aqua amygdalce amarce) is used as a vehicle for narcotic medi- 
cines containing one part of the oil dissolved in 999 parts of distilled 
water. Dose, f§ss. For oleum amygdalce expressum, see index. 

Syrupus Amygdalae [Syrup of Almond), made from both the sweet 
{Amygdala dulcis) and bitter almonds {Amygdala amard), is slightly 
impregnated with the virtues of hydrocyanic acid, and is a pleasant 
vehicle for cough mixtures. (For emidsum amygdala see acacia.) 

Spiritus Amygdalae Amarae [Spirit of Bitter Almond) is made with 
oil of bitter almond, alcohol and water; fgi contains TTLv of the oil. 

AMYL NITRIS— AMVL NITRITE. 

Preparation. — Amyl nitrite (C 5 H n N0 2 ) is prepared by heating 
one part of strong nitric acid with two parts of rectified fusel oil 
(amylic alcohol or amyl hydrate — C 5 H n HO) until it approaches boiling, 
when the fire is removed. 

Properties. — It is a clear amber-colored, volatile, inflammable 
liquid, of sp, gr. 0.872 to 0.874, boiling at about 205 ° F., giving off an 
orange-colored vapor. It has an odor and taste like that of ripe pears. 
It is insoluble in water, but soluble in all proportions in alcohol, ether 
and chloroform. Amyl nitrite should be kept in small glass-stoppered 
bottles, in a dark and cool place. 

Aids. — The depresso-motors, though on account of its peculiar 
nature it should be prescribed alone. 

Physiological Effects. — The following account is based on the 
investigations of H. C. Wood,* Amez-Drozand,f and Lauder Brun- 
ton. % When amyl nitrite is inhaled, it causes flushing of the head and 
face, a feeling of oppression in the head, with vertigo, excited cardiac 
action, diminished blood-pressure, marked dilatation of the arterial sys- 
tem, from paresis of the muscular coat of the vessels, due to direct 
action of the drug (Lauder Brunton, loc. cit.), lowering of temperature, 
retarded respiratory movements, which tend to become slower as the 
administration is pushed, and eventually are extinguished, from a par- 
alyzing influence on the respiratory centre. At the same time there is 
complete motor-paralysis. Consciousness is not destroyed, unless a 
condition approaching death is produced. Equal susceptibility to its 
effects is not experienced by all alike. 

The violent action of the heart is due, probably, to depression of 

* Am. J. Med. Sci., July, 1871, p. 39. 

f Arch, de Phys. Norm, et Pathol., v, 1863, 467. 

XJourn, of Anat. and Physiol., v, p. 92. 



312 MATERIA MEDIC A AND THERAPEUTICS. 

the cardiac inhibitory nerves. On the reflex function and spinal motor 
centres, amyl nitrite acts as a powerful paralyzer. It also lessens the 
functional activity of the muscles and nerves. Dilatation of the vessels 
of the retina has been observed by the ophthalmoscope. Amyl nitrite 
has the property of diminishing the oxidizing function of the red 
blood-corpuscles, uniting with them to form a new compound, methae- 
moglobin, which is not as readily deoxidized as haemoglobin, but which 
may be again converted into the latter by reducing agents. Whether 
inhaled or administered internally, amyl nitrite increases to a marked 
degree both the quantity of urine passed and the amount of uric acid 
and urea eliminated. Sugar has been found in the urine of rabbits to 
which the drug had been administered by hypodermic injection. 

Toxicology and Antidotes. — A teaspoonful,* swallowed by a 
man, aged 60, was not followed with fatal result. His face became blue, 
the extremities cold, respiration shallow, pulse weak and the beats 68. 
After emesis strychnine and digitalis were given to sustain the heart. 
Consciousness was never lost. The lethal effects of amyl nitrite are 
antagonized by those agents which excite the functional activity of the 
spinal cord, as strychnia, picrotoxin, etc. ; also artificial respiration and 
the cold douche. 

Medicinal Uses. — It has been employed to rouse the system in 
cases of syncope and prostration, as an antidote to chloroform poisoning, 
and it has been found efficacious in relieving the pain of angina pec- 
toris, puerperal eclampsia, and other convulsive diseases, and Fraser f 
has recently called attention to the value of the inhalation of amyl 
nitrite to relieve the dyspnoea of asthma. In urcemic asthma especially 
are the good effects of an inhalation of the drug seen, the relief being 
very speedy, the quantity of urine much augmented, and the amount 
of albumen lessened, at the same time the oedema decidedly subsides 
(Ringwood ; Rossbach ; Mya). In cardiac dyspnoea it is also bene- 
ficial. In dysmenorrhoea of the so-called congestive form, it often 
proves serviceable. The inhalation of the vapor of the nitrite is effica- 
cious in arresting epileptic seizures, when their approach is indicated 
by the aura epileptica ; and also in tetanus, nausea marina, and strych- 
nine poisoning. It is indicated in all conditions where there is a high 
degree of tension of the arterioles. The patient should be seated 
during the inhalation. 

* Med. News, Phila., 1893. 

| Am. J. M. Sci., Oct., 1887, p. 393. 



SPINANTS—AMYL NITRITE. 313 

Administration. — It may be conveniently carried in glass-pearls 
by patients requiring its prompt action, and TT|j-v can be inhaled from 
a crushed capsule, or ttL^-i maybe dissolved in alcohol TTL V an< ^ 
swallowed. It should be preserved in dark-colored, glass-stoppered vials. 

The following drugs, although not official, are deserving of notice 
in connection with amyl nitrite. 

Nitroglycerinum [Nitroglycerin — Trinitroglycerin — Glonoin (C 3 H 5 ) 
(N0 3 ) 3 , (not official), is made by the action of sulphuric and nitric 
acids on glycerin. 

Properties. — It occurs as a colorless or pale yellowish, oily 
liquid, with a sp. gr. 1.600; it crystallizes in long needles if kept for 
some time at the temperature of 32 F. ; is nearly insoluble in water, 
but readily soluble in alcohol and ether. It is without odor. Nitro- 
glycerin forms the basis of various explosives, as dynamite, giant 
powder, etc., and will itself explode with great violence if heated in 
a closed vessel or if forcibly percussed. Hay * has made some 
experiments which seem to show that nitroglycerin is a nitrate of 
glyceryl. 

Physiological Effects. — The effects of nitroglycerin resemble 
those of amyl nitrite and the other nitrites, but are more persistent. 
Hay (loc. cit.) considers their similarity of action to be due to the 
nitrous radical contained in each, which coincides with the view 
expressed by Armstrong, f and it appears to be substantially correct. 
When inhaled it causes flushing of the face and headache. Given 
internally, in small doses % (gr. tito), its taste being sweetish and pun- 
gent, it causes very great acceleration of the pulse and respiration, 
diminished blood-pressure, flushed face, a feeling of tension and 
throbbing, and severe headache, pharyngeal constriction, diaphoresis, 
all lasting some hours. After larger doses all of these symptoms are 
intensified ; there is gradual paralysis of reflex and voluntary motions, 
loss of sensation, and finally death from paralysis of respiration. 
Injected into cats Brunton§ found that it produced paralysis without 
tetanus, and in addition it poisoned the muscles. On the motor-nerves 
its action is uncertain. It paralyzed the cord before the ganglia at 
the base of the brain ; slowed the action of the heart directly, and 
reduced the blood- pressure. It is decomposed by the alkalies in the 

* The Practitioner, xxx, p. 422. 

f Med. Times, Feb., 1888, p. 260. 

% British Med. Journal, March, 1880, vol. I, p. 406, article on nitroglycerine. 

£ St. Bartholomew 's Hospital Reports, xii, 1876, p. 140. 



314 MATERIA MEDICA AND THERAPEUTICS. 

blood, the greater portion of the nitric acid of the compound being 
converted into nitrous acid and combining with alkaline bases, forming 
nitrites which lessen the oxidizing power of the red corpuscles and 
cause both arterial and venous blood to assume a dark chocolate hue. 
Nitroglycerin is a muscle-poison, and when applied directly to the 
heart of the frog causes paralysis of that organ. Prof. Rossbach, of 
Jena, finds it greatly increases both the quantity of the urine and the 
amount of uric acid and urea present. 

Toxicology. — Three fatal cases * are recorded, but the amount is 
not given. Its poisonous effects are antagonized by the same agents 
as for amyl nitrite. 

Medicinal Uses. — Nitroglycerin is used to relieve the tension 
of the vessels, as in angina pectoris, in which disease there is pre-emi- 
nently a high arterial tension. Huchardf has recently called attention 
to its efficacy in arteriosclerosis, in which the vascular pressure is 
above the normal. If taken at the beginning of the attack of asthma 
(especially ,if due to emphysema), it will frequently give good results 
(Korczynski). In urcemic asthma it is often useful, but if the symptoms 
are urgent, it is best to let the patient inhale amyl nitrite until the 
danger is abated, after which nitroglycerin should be administered. 
The prolonged use of nitroglycerin is recommended by Osier J in 
locomotor ataxia with increased arterial tension, to relieve the neuralgic 
pains and diminish the frequency of the crises. 

In puerperal eclampsia it has been of great service, and has also 
been recommended in cardiac dyspnoea, due to dilatation, and in weak 
heart, or where fatty degeneration of the cardiac muscle is taking 
place ; although many prefer the use of amyl or other nitrite in these 
cases. It may be useful in acnte Bright s disease, given early to 
depress the arterial tension, always exaggerated in this condition. It 
sometimes affords relief in neuralgias and in gastrodynia, and it has 
been found efficacious in arresting the vomiting of sea-sickness. 

Administration. — The dose is gr. ih-io, best given in granules. 
It is best to begin with a small dose and gradually increase it. Spirit 
of nitroglycerin (spiritus glonoini) has been added to the U. S. P. of 
1890, and contains 1 per cent, by weight of the substance. Care must 
be used in handling this preparation; dose, gtt. j, t.d., gradually in- 
creased. 

* Woodman and Tidy, 1882, p. 464. 
f Bull. Gen. de Therap., 1892, p. 98. 
% Practice of Medicine, p. 848, 1892. 






SPINANTS— JASMINE. 315 

Potassium Nitrite and Sodium Nitrite have been introduced into 
practice as being similar in effects and uses to those of amyl nitrite 
and nitroglycerin, and this similarity has recently been corroborated 
by Armstrong (loc. cit.) and Reichert* in some experiments on the 
pharmacology of the nitrites (Huchard|). 

Effects and Uses. — Dr. Matthew Hay J believes the sodium salt 
to be as active and reliable in angina pectoris (also good results reported 
by Gordon Sharp), as either of the above drugs, and prefers it, 
because when used in medicinal doses, it does not cause the headache, 
giddiness, or even partial collapse, which are sometimes seen after 
their use. The nitrites have recently been recommended in asthma 
by Fraser. 

Toxicology. — So much as gr. 48 have been taken by an adult in 
24 hours without fatal result. There was faintness and a feeling of 
dissolution. Recovery followed under digitalis and stimulants. 

Administration. — Dose, gr. iij-v or more, in aqueous solution. 

GELSEMIUM— JASMINE. 

Description and Habitat. — Gelsemium sempervirens, Yellow 
or Carolina Jasmine (Nat. Ord. Loganiace^e), is a beautiful climbing 
plant of our Southern States, with a twining, smooth and shining 
stem, perennial, dark-green leaves, and beautiful, very fragrant flowers, 
of a deep-yellow color. The rhizome and root are official. 

Properties. — They are long, cylindrical, externally yellowish- 
brown, with purplish longitudinal lines ; bark thin with silky fibres adher- 
ing to the yellowish porous wood, which has medullary rays. The rhi- 
zome is distinguished from the root by a small central cavity, 
representing the pith. The root has a bitter and pleasant flavor, and 
an odor somewhat between that of senega and green tea. 

Chemical Constituents. — It contains an alkaloid termed gelse- 
wiine (C M H 69 N 4 12 ), combined with an acid called gelseminic, both dis- 
covered by Wormley § (not identical with aesculin), a volatile oil, an 
acrid resin, etc. The alkaloid, which represents chiefly the physiolog- 
ical action of the drug, though Ott || has shown gelseminic acid, 
gr. ]-y 2 injected into cats to be a fatal tetanizer, is a powerful poison. 



*Am. Jour. Med. Set, Vol. 80, p. 158. 

f Societe de Therap., 1893. % Practitioner, March, i< 

\ Am. Jour n. of P harm., Jan., 1 870, and July, 1882. 

|| Phil. Med. Times, v, July, 1875, and March 31, 1887. 



316 MATERIA MEDICA AND THERAPEUTICS. 

Incompatibles. — The caustic alkalies and tannic acid precipitate 
the alkaloid. 

Aids. — The depresso-motors, as tobacco, physostigma, conium, 
etc. 

Physiological Effects. — The action of gelsemium has been in- 
vestigated and described by the following observers, viz., Bartholow,* 
Ott (life. cit.) y Ringer and Murrell,f Holmes,} and A. R. Cushny,§ as 
follows : The taste of the preparations of gelsemium is bitter. In 
moderate doses, it causes languor, dizziness, disordered vision and 
frontal pain, but hardly affects the circulation. Large doses diminish 

Fig. 29. 




GELSEMIUM SEMPERVIRENS. 



the pulse and blood-pressure by direct action on the heart, lower the 
temperature of the body, lessen respiration, and dilate the pupils, with 
little or no nauseating or purgative effect, nor does it exhibit any char- 
acteristic influence upon the brain. Ott's (loc. cit.) conclusions are 
these, viz., that gelsemine has no action on the motor or sensory 
nerves, nor on muscular contractility, which are in accord with those 
of Bartholow (loc. cit) ; the last observer concludes that its paralyzing 
influence is due to a direct action on the motor and sensory centres of 
the cord. It appears to slow the heart by direct action, and it destroys 
life by paralysis of respiration. By summing up its action, after ex- 
amining the effects of lethal doses, and the results of experiments, we 
can deduce the fact that gelsemium is a powerful depressant, not only 
of the motor, but also of the sensory centres, in the spinal cord. 

* The Practitioner, v, p. 200. 

f The Lancet, Jan. 15th, 1876. 

% Annuaire de Therapy 1877, p. 41. 

\ Arch. f. exper. Pathol, u. Pharm., 1892-3, p. 4$. 



SPINA NTS— WO ORARA. 317 

Toxicology and Antidotes. — In overdoses, it has rapidly pro- 
duced death, with great muscular relaxation, want of coordination in 
the movements, difficulty of speech, double vision, dilatation of the 
pupils, failure of the pulse and respiration, coldness of the surface, and 
finally unconsciousness preceding death. Ott * has collected six cases 
of fatal poisoning by gelsemium, the minimum dose being f5j of the 
fluid extract. An amount of gelsemium estimated to contain gr. \ ot 
gelsemine has proved fatal to an adult woman. Its lethal effects are 
counteracted by the cardiac and motor-excitants, as strychnia, ammo- 
nia, alcohol, etc. 

Medicinal Uses. — It has been used in fevers, inflammations, in 
nervous affections, as tetanus, as a motor-depressant to alleviate par- 
alysis agitans, and as an anodyne in trifacial neuralgia. As a calmative 
in acute mania it has been given in full doses, and as a depresso- motor 
against the erotic desires of spermatorrhoea and those leading to mas- 
turbation. Bulkley f advises the internal use of tincture oi gelsemium 
gtt. x, repeated, to relieve the itching of acute eczema and prurigo. 

Administration. — The tincture of gelsemium (tinctura gelsemii) is 

given in the dose of TTLv-xx ; the fluid extract (extractum gelsemii 

fluidwn), dose, Tltv-x; f5j of this has proved fatal. Of gelsemine, the 

dose is gr. 6V-2V. 

woorara. 

Description and Habitat. — This substance (not official), termed 
also woorari, woorali, and curare, has long been known as a powerful 
poison prepared by the Indians, in South America, and of late years 
has been employed as a medicine. Its source is unsettled, but it is 
generally considered to be an extract from the bark of Strychnos tox- 
ifera and other species of Strychnos. It is brought from the banks of 
the Orinoco. 

Properties and Constituents. — It occurs in the form of dark- 
brown or grayish lumps or powder, soluble in water, of a bitter taste, 
and, when triturated, of a powerful odor. An alkaloid termed curarine 
(C 18 H 35 N) has been extracted from woorara, which is said to exist as a 
sulphate (Sachs). Another alkaloid termed citrine has been discovered 
by B6hm (1886). 

Incompatibles. — The caustic alkalies and tannin decompose the 
alkaloids. 

Aids. — The depresso-motors, as physostigma and conium. 

* Phila. Med. Times, Vol. v, p. 689. | N - Y - Med.Journ., Jan., 1 881. 



318 MATERIA MEDICA AND THERAPEUTICS. 

Physiological Effects. — Woorara, topically applied, is an irri- 
tant. Its taste is bitter. It is ranked with the motor-depressants, and 
is considered to destroy life by paralysis, more or less rapid, of the 
respiratory muscles. A peculiarity of its action is that it is compara- 
tively innocuous when taken by the stomach, being either not absorbed 
at all in this viscus, or so slowly as to allow of its elimination by the 
kidneys before dangerous accumulation in the blood. According to 
Lauder Brunton, on introduction into the stomach the absence of 
poisonous effects of curare is due, probably, to its being passed round 
the entero-hepatic circulation. Hence, for therapeutic purposes, it 
must be employed either endermically to a blistered surface or by 
hypodermic injection. Woorara paralyzes the intra-muscular motor- 
nerve endings without affecting the muscular irritability, and destroys 
the reflex function of the spinal cord : in other words, the paralysis 
induced by it is peripheral and not centric ; eventually, however, the 
paralyzing action of woorara extends to the nerve-trunks and centres. 
The cerebrum is only secondarily involved. Woorara stimulates and 
then paralyzes the accelerator cardiac nerves. Other effects of woorara 
are elevation of temperature, increase of the nasal, salivary and intestinal 
secretions, and diabetic urine (in animals). The elimination of cura- 
rine has been distinctly shown to take place, in part, by the kidneys. 

Toxicology. — Artificial respiration retards the poisonous effects 
of the drug ; also the tetanizers, and chloral to a certain extent. 

Medicinal Uses. — Woorara, or curarine, is only applicable to 
the treatment of those affections which therapeutically require motor- 
depressants to antagonize the disease-process. Among the most 
prominent of these are tetanus and rabies. In tetanus good results 
have been obtained from its use in large doses, while from rabies there 
are two reported cases of recovery. It has been employed in paralysis 
agitans. 

Administration. — The dose of woorara is from ^ to i of a grain, 
in pill. Of curarine, from gr. ^ to T £o, hypodermically. Caution must 
be enjoined, as the samples vary. 

VIBURNUM PR UNIFOLIUM— BLACK HAW. 

Description and Habitat. — Viburnum is the bark of Viburnum 
prunifolium, commonly known as the Sloe or Black Haw (Nat. Orel. 
Caprifoliaceae), a small tree growing in thickets in the Southern and 
Western States, with opposite, oval, obovate, sharply serrulate leaves 
about two inches long, and short, slightly marginal petioles. It has 



SPINA NTS— VIBURNUM OPULUS 319 

small white flowers in terminal cymes, appearing in May; and small, 
blue-black, edible drupes containing a flattish, smooth putamen. 

Properties and Constituents. — The bark is in thin pieces or 
quills of a purplish-brown color, with scattered warts and minute black 
dots; collected from the old wood it is a grayish-brown, the thin, 
corky layer easily removed from the green layer ; the inner surface is 
whitish and smooth ; it breaks with a short fracture, and is without 
smell. It contains valerianic acid, a brown bitter resin, a greenish- 
yellow bitter-principle (yiburnin), tannin, etc. 

Incompatibles. — As it contains tannin it is incompatible with 
the substances precipitated by this agent. 

Physiological Effects. — It has a bitter astringent taste. The 
physiological effects of viburnum are not understood. It probably 
acts as a sedative to the spinal centres, especially those governing the 
uterine functions ; but whether it influences the circulation or the 
blood-supply to the uterus, or what action, if any, it has on the sym- 
pathetic ganglionic system are questions for the future to determine. 
It is said that no disagreeable after-effects attend its use. 

Medicinal Uses. — Viburnum has been administered as a Sedative 
in cases of threatened abortion* whether accidental or due to the action 
of drugs, and it is said to be especially serviceable where a tendency 
to abortion exists from habit. In these cases 5j may be given every 
two or three hours as long as the abortion is threatening. It is also 
recommended to allay the severity of after-pains, and is one of the 
numerous remedies which have been used for the relief of the vom- 
iting of pregnancy. It has also been employed with success in menor- 
rfyagia and metrorrhagia, depending on anaemia, debility or other 
systemic cause, and in menorrhagia accompanied with nervous 
symptoms appearing at the climacteric period. It has been given, 
too, in dysmenorrhoea f with profuse discharge, accompanied by a feel- 
ing of weight in the pelvis, and may be combined with other remedies 
in the treatment of neuralgic dysmenorrhoea. 

Administration. — The fluid extract {extractum viburni prunifolii 
fluidum) is official, the dose of which is f5ss-j. 

VIBURNUM OPULUS-CRAMP BARK 

Description, Habitat and Properties. — This is the bark of the 
Viburnum Opulus {Nat. Ord. Caprifoliaceae), a tall handsome shrub, 

* Liverpool Med. and Surg. Journal, 1875, p. 41, J. H. Wilson. 
f "New Preparations," 1879, p. J 37- 



320 MATERIA MEDICA AND THERAPEUTICS. 

common in the Middle and Southern States, its fruit resembling the 
cranberry. In comes in curved bands, or quills, of an ash-gray color 
externally, and marked with brownish warts or dots. 

Chemical Constituents. — A bitter-principle, viburnin (Kramer) 
and volatile oil have been extracted. 

Effects and Uses. — Its taste is astringent and bitter. As yet its 
effects are not well understood; it is, however, given empirically as a 
uterine sedative in dysmenorrhcea. 

Administration. — The fluid extract (extractum viburni opidi 
fluidum), is official ; dose, f5i-ii. 

grindelia. 

Description and Habitat. — Grindelia is the leaves and flower- 
ing tops of the Grindelia robusta and G. squarrosa {Nat. Ord. Com- 
positae), an herbaceous perennial plant growing to the height of one 
or two feet, indigenous to the Pacific coast. It resembles the common 
sunflower in its general appearance. 

Chemical Constituents. — It contains vegetable wax, fixed arid 
volatile oils, a greenish, soft, acid resin having the odor of the drug, an 
acid saponin-like body (grindelin), a trace of tannin, but no alkaloid 
(W. H. Clark).* 

Incompatibles. — The volatile oils and resin of grindelia are not 
miscible with preparations containing water. 

Aids. — The depresso-motors. 

Physiological Effects. — Locally, it is weakly astringent and 
sedative. Its taste is aromatic and bitter. In large doses grindelia 
exerts a decided hypnotic effect, during which the pupils are dilated 
and reflex action, motion, and sensation are depressed. Bufifington'st 
investigations give the following results : the cardiac action is slowed 
by grindelia, through stimulation of its inhibitory centre, while the 
local blood-pressure is raised. The statement as to the slowing of the 
heart and reduction of blood-pressure are confirmed by Dobroklonsky.t 
The respiratory movements are increased in frequency by an action 
of the drug on that centre. It is eliminated by the kidneys, inducing 
a marked increase in the urinary flow and to a certain extent by the 
lungs. The statement in regard to its diuretic action is not confirmed 



* American Jour, of Pharmacy, Sept., 1888. 

f Am. Jour. Med. Set., Jan., 1886. 

I These de St. Petersburg. Quoted by Bull.'" Gen. de Therap., CXI, 277. 



SPINA NTS— SUMBUL. 321 

by Dobroklonsky (loc. cit), who affirms that it is feebler in this respect 
than digitalis. 

Toxicology. — Grindelia is not actively toxic, though a lethal dose 
will destroy life by arrest of respiration. Its poisonous effects are 
counteracted by the spinal excitants, strychnia for example. 

Medicinal Uses. — Grindelia is serviceable in the treatment of 
asthma, especially in the uncomplicated spasmodic form, but it has 
also proved useful when this disease is complicated with bronchitis. 
In many cases of hay-fever it has proved of benefit, and it has been 
recommended in acute and chronic bronchitis and pneumonia. It has 
been employed as an injection in vaginitis and as a topical application 
in poisoning by rhus toxicodendron (dermatitis venenata), the latter with 
varying results. 

Administration. — The fluid extract (extractum grindelice robustce) 
is official, the dose of which is Tftx-f5j- An extract can be had, dose 
gr. 3-10. 

SUMBUL. 

Description and Habitat. — Sumbul is the root of the Ferula 
Sumbul {Nat. Ord. Umbelliferse), a perennial plant, growing to the 
height of eight feet, with large triangular, tripinnate radical leaves and 
a few small cauline leaves. It is a native of Turkestan and Eastern 
Siberia. 

Properties. — The root is met with in transverse slices from one 
to five inches in diameter and three-quarters to two inches thick. It 
is light, spongy, annulated, with a thin brownish bark and a whitish 
interior, with numerous dots of brown-yellow resin and irregular, 
easily separated fibres ; and of a strong musk-like odor. 

Chemical Constituents. — Sumbul root contains a volatile oil, a 
soft resin, angelic and valerianic acids (Maisch). The soft oleoresin is 
soluble in ether, exists in the proportion of 9 to 100, and imparts to 
water the odor of musk (Remsch).* 

Effects and Uses. — The taste of sumbul is bitter and balsamic. 
The physiological effects of sumbul are not accurately known. It 
probably acts as a sedative to the brain and spinal cord. In England 
it has 'been used in dysmenorrhea, hysteria, and various allied nervous 
disorders. Phillips recommends it in severe cases of facial, sciatic, or 
ovarian neuralgia. Boehm (Ziemssen's Cyclopcedia) speaks favorably 
of it in delirium tremens. 

* Journ. de Pharm. et de Chimie, 4i£me ser., 1871, p. 320. 
21 



322 MATERIA MEDIC A AND THERAPEUTICS. 

Administration. — The tincture (tinctura sumbul) may be pre- 
scribed in doses of TTLx-f5j. It is much given in pill-form ; !R Ext. 
sumbul, ferri sulph. exsic, aa gr. j ; asafcetidae, gr. ij ; acid, arsenosi, 
gr. 3V. M. S. — One, three or four times daily. 

ASPIDOSPERMA. 

Description and Habitat. — This is the bark of Aspidosperma 
Quebracho-bianco [Nat. Ord. Apocynacese), a tree of South America, 
where it is used on account of the hardness of its wood. 

Properties. — By the U. S. P. it is described as occurring " in 
nearly flat pieces, about I to 3 cm. thick, the outer surface yellowish- 
gray or brownish, deeply fissured," the inner surface is yellowish or 
reddish-brown, and striated ; it is inodorous. 

Chemical Constituents. — Schicedanz has isolated a crystalline 
alkaloid aspidosp ermine (C22H 30 N 2 O 2 ) ; others have obtained aspidosper- 
matine (C 22 H 28 N 2 2 ), aspidosamine (C 22 H 28 N 2 2 ), quebrachine (C 21 H 26 
N 2 2 ), hypoquebrachine (C 21 H 26 N 2 2 ), and quebrachamine (Hesse). The 
sulphate and hydrochlorate of aspidospermatine are soluble in water. 

Physiological Effects. — The action of this drug is not yet fully 
understood. Its taste is bitter and somewhat aromatic, the disagree- 
able taste, in some cases, producing nausea. The alkaloids doubt- 
lessly are dissolved out by the gastric fluid and osmose into the 
blood. In animals killed by the alkaloids the venous blood remained 
red or reddish. They produce motor paralysis in frogs. In warm- 
blooded animals the voluntary movements, and the respiration and 
heart, are paralyzed by aspidospermine in lethal doses ; the respiration 
is increased by medicinal amounts. 

Medicinal Uses. — It is given in asthma, with emphysema, even 
though there be effusion into the pleura. It is not efficient in the 
dyspnoea of weak heart (Pluzoldt). It seems most serviceable in 
functional dyspnoea. 

Administration. — The fluid extract {extr actum aspidosp ermatis 
fluidum) is official ; dose, Hlxv-f 5j. 

CLASS II.— ECCRITICS. 

ORDER I.— EMETICS. 

Emetics (from 'epiiv, I vomit) are medicines which are employed 
to promote vomiting ; when they are used merely to excite nausea, 
they are termed nauseants. When an emetic is administered, usually 



EMETICS. 323 

within fifteen or twenty minutes afterward a feeling of distress, relaxa- 
tion and faintness is experienced, with coolness and moisture of the 
skin, a small, feeble, irregular pulse, and an increased flow of saliva. 
These symptoms increase till the contents of the stomach are ejected. 
During the act of vomiting the face becomes flushed, the pulse is full 
and frequent, and the temperature of the body is increased. After 
vomiting is over, the skin is moist, the pulse soft and feeble, the pa- 
tient becomes languid and drowsy, and, under peculiar circumstances, 
alarming and even fatal syncope has been induced. Emetics act 
either directly on the centres of the medulla which govern the act of 
vomiting, or by local irritation in the stomach, which impression being 
conveyed to the vomiting centre by filaments of the pneumogastric 
nerve, produces emesis in a reflex manner. In the former case, vomiting 
is produced by the drug, no matter in what manner it enters the system, 
and it is, therefore, called a systemic emetic ; in the latter, vomiting is only, 
produced by the introduction of the substance into the stomach, and 
it is hence called a local emetic. Some agents, however, act in both 
ways, as copper sulphate. Reflex vomiting may be excited by irritat- 
ing the fauces, as with a finger or feather, the glosso-pharyngeal nerve 
being the afferent bearer, or by the conveyance of the impressions of 
certain nauseous smells, tastes, sights and ideas along the afferent 
nerves of particular organs, as the nose, to the vomiting centre. Dr. 
Marshall Hall gives the following summary of the mechanism of 
vomiting: "During the act of vomiting, I, the larynx is closed; 2, 
the cardia is opened; and 3, all the muscles of expiration are called 
into action; but, 4, actual expiration being prevented by the closure 
of the larynx, the force of the effort is expended upon the stomach, 
the cardiac being open, and vomiting is effected." 

The systemic emetics are ipecacuanha, sanguinaria, apomorphia 
and tartar emetic; the local, zinc and copper sulphates, mustard, alum, 
and salt and water. 

Susceptibility to the action of emetics differs in different indi- 
viduals and in different diseases. In fevers, and where gastric irrita- 
tion is present, their influence is increased; and, on the other hand, 
when the brain is oppressed by disease or by narcotic medicines, 
the stomach is exceedingly insensible to their action. Children 
vomit more readily than adults, since the stomach of a child has no 
fundus. 

Contraindications. — They are improper where the effort of 
vomiting is liable to increase any existing pathological conditions, as 



324 MATERIA MEDICA AND THERAPEUTICS. 

in congestion of the brain, a tendency to pulmonary haemorrhages, 
pregnancy, hernia, aneurism, atheroma, etc., or where such debility is 
present that the depressing effects may prove fatal, as in the last stages 
of membranous croup. 

Medicinal Uses. — Emetics are employed therapeutically — i, to 
evacuate the stomach, for the purpose of removing poisons, undigested 
food, etc. ; and, with this view, the emetics should be selected which 
occasion least nausea and distress ; 2, to expel for eig7i bodies lodged in 
the throat or oesophagus ; 3, to excite nausea, and thereby depress the 
vascular and muscular systems, thus acting as anaphrodisiacs; 4, to 
relieve spasm, as in spasmodic croup, hiccough, laryngysmus stridulus, 
and convulsions; and 5, to promote secretion and excretion, etc. 

The act of emesis is promoted by the free use of tepid drinks ; 

excessive vomiting may be checked by demulcents, opiates, calomel 

and bismuth, counter-irritation to the stomach, and cracked ice slowly 

swallowed. 

VEGETABLE EMETICS. 

IPECACUANHA- IPECAC. 

Habitat. — Ipecacuanha is the root of Cephaelis Ipecacuanha 
(Nat. Ord. Rubiaceae), a small shrubby perennial plant of Brazil, 
where it grows to the height of about five or six inches. 

Description and Varieties. — The roots, as met with in the 
shops, are in pieces about the size of a quill, several inches long, of 
an irregular, twisted, contorted shape, with numerous circular rings or 
rugae from which they have been termed annidated. When broken, 
they are seen to consist of two distinct parts — a thin ligneous axis or 
centre, which is nearly inert, and a thick, cortical layer, which has an 
herbaceous, acrid, rather bitter taste and a slightly nauseous odor. A 
distinction is made of black, red and gray ipecacuanha, from differences 
in the color of the epidermis; but they are all derived from the same 
plant, and are the same in properties and composition. The black is 
the most common variety in our market. The powder is of a light 
grayish-fawn color, and has a peculiar nauseous odor, which in some 
persons excites violent sneezing, in others, dyspnoea. Ipecacuanha 
imparts its virtues to both water and alcahol, but they are injured by 
decoction. 

Chemical Constituents. — Its emetic property depends on the 
presence of an alkaloid, termed emetine (C 30 H 40 N 2 O 5 ) (Kunz *), which 

* Arch, der Pharmacie, 1 887, p. 461. 



EMETICS— IPECA C. 



325 



exists in connection with ipecacuanhic acid. Emetine is a whitish, 
inodorous, slightly bitter substance, sparingly soluble in water and 
ether, and very soluble in concentrated alcohol and chloroform. It 
produces vomiting in the dose of gr. J^, and in over-doses may occa- 
sion dangerous and even fatal symptoms. 

Incompatibles. — Tannic acid, the astringent infusions, caustic 
alkalies, and metallic salts. 

Aids — The emetics, as apomorphia, also warm diluents. 

Fig. 30. 




CEPHAELIS IPECACUANHA; 0, b, ROOT; a, ANNULATED PORTION. 



Physiological Effects. — Locally, powdered ipecac is an irritant 
to raw surfaces and to the mucous membranes, and it causes violent 
sneezing if introduced within the nose. When rubbed upon the sound 
skin it produces pustulation and even ulceration. Its taste is bitterish 
and nauseous. In very small doses (gr. J^-j£) it is a gastric stimu- 
lant ; in larger, it is an irritant to the stomach, producing vomiting by 
local irritation as well as by direct action on the medulla. Secretion : 
repeated small doses relax the skin and increase the perspiration, 
saliva and the bronchial and gastric mucus. Rutherford states that it 



326 MATERIA MEDICA AND THERAPEUTICS. 

has the power of stimulating the secreting apparatus of the liver (in 
dogs), and that the consequently augmented secretion of bile is normal 
in composition as regards the biliary matters proper. It also increases 
the secretion of intestinal mucus. Nervous system : it stimulates the 
centre of the medulla oblongata which presides over the act of vomit- 
ing, and somewhat diminishes the reflex activity of the cord. The 
following observers, viz.: D'Ornellas,* Phillips,"}" and Duckworth,^ 
ascertained that emetine, in animals, always caused vomiting, given 
either by the stomach or subcutaneously. D'Ornellas {loc. cit.) and 
Duckworth {loc. cit) found, too, that when the vagi were divided in the 
neck the alkaloid was powerless as an emetic. Toxic doses (in ani- 
mals) generally destroy life by paralyzing the respiratory centres, the 
nerves probably remaining unaffected. Circulation : moderate doses, 
probably do not affect the circulation; very large doses injected into 
the jugular vein of dogs have killed by cardiac paralysis. Tempera- 
ture : in the mouth and on the surface the temperature falls in cases 
of emetine poisoning, but in the intestines it rises (from the irritant 
action of the poison). Elimination takes place by the gastrointes- 
tinal mucous membrane, and also by other secretions. 

Medicinal Uses. — In full doses, ipecacuanha is a mild and cer- 
tain emetic, well adapted to the treatment of spasmodic croup (of the 
wine f 5ij) and acute bronchitis in children, and to all cases where a 
simple evacuation of the stomach is desired. In smaller doses it pro- 
duces nausea, depression of the pulse, expectoration and diaphoresis, 
and with these views it is employed in the treatment of pulmonary affec- 
tions, as acute bronchitis. In still smaller doses it is useful as a tonic 
and stomachic. At the onset of yellow fever an ipecacuanha emetic 
followed by a full dose of quinine may be given. 

Ipecacuanha was introduced as a remedy in acute dysentery, and, 
after being for a time laid aside, has been again taken up with marked 
success. It is particularly of value in epidemic dysentery, and in 
India is used in very large doses in this affection, as much as 5ij 
being sometimes given every few hours. Good effects often follow its 
use in acute dysentery of sporadic kind, especially when occurring in 
puerperal women, given in doses of gr. xv-xx combined with opium 
every three or four hours. If no effect is produced by the ipecac- 

* Bull. Gen. de Therapy LXXXIV, pp. 193, 244, 348; Du Vomissement, etc. 
| Practitioner, London, III, p. 276. " On the action and uses of ipecacuanha." 
% Ibid., Vol. V, p. 218, and Vol. VII, p. 91. "Observations upon the action of ipe- 
cacuanha," etc. 



EME TICS—SANG UINARIA. 327 

treatment of dysentery in two days, it is best to abandon it. It is also 
given with advantage in the vomiting of migraine •, and will sometimes, 
when given in small doses, frequently repeated, arrest the nausea and 
even the vomiting of pregnancy (Fuller*). The wine or fluid extract 
(in drop doses) is best for this purpose. Given in pills containing gr. 
%-^i before meals, it is of service in dyspepsia accompanied by de- 
ficiency of gastric and biliary secretions. As it stimulates the secretory 
apparatus of the stomach and liver, the rationale is obvious. At the 
onset of acute gastritis, if due to undigested food, gr. v-x of ipecac 
should be given. 

Administration. — Dose, as an emetic, gr. xv-xx; as a nauseant, 
gr. ss-ij, three or four times a day; as an expectorant or diaphoretic, gr. 
%-yzy repeated; as a tonic, gr. to, repeated; all dispensed in powders 
with sugar of milk. The fluid extract (extr actum ipecacuanha fluidum) 
is used as an addendum to expectorant and diaphoretic mixtures, and 
in bronchitis is advantageously combined with the syrup of wild cherry 
and morphine. As an emetic, the dose is f§ss-j ; the wine (vinum 
ipecacuanhce) contains fluid extract 10 parts, alcohol 10 parts in stronger 
white wine 80 parts; dose, as an emetic, fgss-j; syrupus ipecacuanha?, 
an excellent preparation for children — f§j containing gr. xxx of ipe- 
cacuanha; for a child a year or two old, f5ss-j may be given as an 
emetic, and gtt. x-xx as an expectorant. Pidvis ipecacuanhce et opii 
{Dover's powder} contains powdered ipecac and opium each gr. j, sugar 
of milk gr. viij (see p. 92); a tincture of ipecac and opium is also official 
(see p. 92). Troches of ipecacuanhce (trochisci ipecacuanhce) contain also 
sugar, tragacanth, and syrup of orange-peel), each troche contains 
ipecac gr. y^. Troches of morphine and ipecac (trochisci morphine et 
ipecacuanha) each contain morphine sulphate gr. to-, ipecac gr. tV, with 
sugar, oil of gaultheria and mucilage of tragacanth. 

SANGUINARIA— BLOODROOT. 

Description and Habitat. — The rhizome of Sanguinaria cana- 
densis, collected in the autumn (Nat. Ord. Papaveracese), a small 
indigenous plant, with radical, lobate reniform leaves and a handsome 
white eight-petaled flower, which appears in early spring, is usually 
classed with emetics. When dried it comes in flattened pieces, much 
wrinkled and contorted, of a reddish-brown color, with a faint narcotic 
odor and a bitterish, very acrid taste. 

* Lancet, London, Dec. 4th, 1869, p. 268. 



32S 



MATERIA MED1CA AND THERAPEUTICS. 



Chemical Constituents. — It yields its virtues to water and 
alcohol, and loses them very rapidly by keeping. An alkaloid, 
sanguinarine (C 19 H 17 NOJ, has been obtained from it which possesses 
the properties of the root. 

Incompatibles. — The alkalies, tannic acid and metallic salts. 

Aids. — The vegetable and mineral emetics. 

Fig. 31. 




SANGUINARIA CANADENSIS. 



Physiological Effects. — Locally, it acts as an irritant, and upon 
fungous surfaces, as an escharotic. When inhaled, the powder causes 
violent sneezing. Bloodroot is an acrid emetic, and, in large doses, an 
acro-narcotic poison. Bloodroot has a persistent, bitter taste, and in 



EMETICS— APOMORPHINE HYDROCHLORATE. 329 

passing to the stomach leaves a feeling of constriction about the 
throat In large doses it causes collapse, dilated pupil, and sometimes 
convulsions of spinal origin, and it diminishes reflex activity. After 
nauseating doses the pulse and arterial pressure are increased, but 
when enough is taken to produce vomiting the pulse is slow and irreg- 
ular and the arterial tension is lowered. After poisonous doses the 
respiration becomes shallow and slower, and death takes place from 
asphyxia, due to paralysis of the respiratory centre. 

Sanguinaria * produces salivation and increases the secretion of 
the gastric mucous membrane. It stimulates the liver and intestinal 
glands, increasing the secretion of bile, but at the same time rendering 
it more watery (Rutherford). It is an active systemic emetic, causing 
much depression and irritation of the mucous membrane. 

Medicinal Uses. — It is not much employed as an emetic, but is 

occasionally exhibited with this view in croup and diphtheria, or as an 

expectorant in pulmonary affections. In duodenal catarrh and catarrhal 

jaundice it has been used with advantage. It has also been prescribed 

as an emmenagogue in amenorrhcea. 

Administration. — Dose, as an emetic, gr. x-xx, in pill. Tincture 
(tinctura sanguinarice) — dose, as an emetic, f5iij or iv ; as an expecto- 
rant, TTLv-xxx. The fluid extract (extractum sanguinarice fluidmn) 
should be used with care, as it is a powerful preparation ; dose, as a 
nauseant, ^lij-v; as an emetic, THxv-f5j. 

APOMORPHINE HYDROCHLORAS-APOMORPHINE HYDROCHLORATE. 

Preparation and Properties. — Apomorphine (C 17 H 17 N0 2 ) is an 
artificial alkaloidal substance obtained by heating morphine or codeine 
with hydrochloric acid under pressure, the acid subtracting one 
molecule of water from a molecule of morphine, and leaving apomor- 
phine (C 17 H 19 N0 3 =H 2 0-hC 17 H 17 N0 2 ). When apomorphine is treated 
with hydrochloric acid it combines to form the official salt (C 17 H 17 N0 2 
HC1). When pure it is a white powder, but it absorbs moisture 
readily, becoming green, which change, however, is said not to impair 
its therapeutic properties. It is soluble in 45 parts of water. 

Physiological Effects. — Its taste is faintly bitterish. Apomor- 
phine is chiefly of interest therapeutically on account of the emesis 
which follows its administration, to which attention was first called, 

* For the details of a complete investigation of the action of Sanguinaria consult Am. 
J. M. Set., Oct., 1876, p. 346, by R. M. Smith, m.d. 



330 MATERIA MEDICA AND THERAPEUTICS. 

we believe, by Dr. S. J. Gee.* It is a prompt and efficient systemic 
emetic, causing vomiting within a half hour after it is taken, which is 
repeated two or three times at intervals of about fifteen minutes, and 
is attended by slight nausea and usually little or no depression. Given 
to animals in large doses, it at first stimulates the nerve-centres and 
afterward paralyzes them. Convulsions are produced, but their origin 
is not precisely determined, and it is a poison to the muscular system. f 
Small doses increase the cardiac action and elevate the blood-pressure, 
but when large doses are taken, the cardiac movements are probably 
slowed and the pressure diminished. According to Reichert (Joe. cit.), 
it quickens the heart's beats by stimulation of its accelerator fibres, and 
slows it by a direct repressing influence on its muscular substance. 
Very large doses may have a decided sedative action on the circulation 
(in man), and even induce syncope. Large doses at first increase the 
number of the respiratory movements, but afterward diminish them. 

Toxicology. — A poisonous dose destroys life by asphyxia, death 
being due to the action of the drug on the respiratory centre. 

Medicinal Uses. — Apomorphine may be used as an emetic hypo- 
dermically or by the stomach, in cases of narcotic poisoning or where 
it is desirable to evacuate the contents of the stomach promptly. It 
has also been used as an expectorant in both acute and chronic bron- 
chitis, and in the capillary bronchitis of infants. Trousseau recom- 
mends it in hemoptysis. 

Administration. — Dose of the hydrochlorate (apomorpliince hydro- 
chloras) is gr. 2V-1V hypodermically, or }4 or perhaps ^ by the 
stomach. It may be had in hypodermic tablets. It should be given 
cautiously, on account of the depression which occasionally accom- 
panies its action. 

' Sinapis (Mustard). — The powdered seed of Sinapis nigra and 
Sinapis alba (Nat, Ord. Cruciferae), in doses of from a teaspoonful to a 
tablespoonful, are very useful emetics, particularly in atonic conditions 
of the stomach. 

Tobacco and Lobelia act as emetics in large doses, but their 
employment is attended with danger owing to the great prostration 
which they produce (see pp. 304; 306). Squill also possesses emetic 
powers, but it is too irritating for use in this respect. 

^ - ■ 

* St. Barthol. Hosp. Reports, v, 215. 

| Phila. Med. Titties, Dec, 1879, E - T - Reichert. ' ' Physiolog. Action of Apo- 
morphine hydrochlorate." 



CATHARTICS. 331 

MINERAL EMETICS. 

Tartar Emetic. — Dose, gr. j-ij (see p. 250). 
Zinc Sulphate. — Dose, gr. x-xx (see p. 199). 
Copper Sulphate. — Dose, gr. iij-v (see p. 197). 
Alum. — Dose, a teaspoonful (see p. 208). 

Yellow Mercurial Sulphate or Turpeth Mineral. — Dose, 
gr. ij-v (see index). 

ORDER II. CATHARTICS. 

Cathartics (from xadaipw, I purge), or purgatives, are medicines 
which produce evacuations from the bowels. Some operate by in- 
creasing the peristaltic motion of the intestines ; others stimulate the 
mucous follicles and exhalants, and occasion watery evacuations, 
whence they are termed hydragogues. The more violent of the hydra- 
gogues, if given in over-doses, produce inflammation of the alimentary 
canal, characterized by violent vomiting and purging, abdominal pain 
and tenderness, cold extremities and sinking pulse. From their 
activity they are often denominated drastics. Different cathartics affect 
different parts of the alimentary canal unequally, some acting more 
particularly on the upper portion, some on the lower, and others 
affecting all parts equally. 

Cathartics may be arranged in five groups : 1. Laxatives, which 
gently evacuate the contents of the bowels, without causing any 
obvious irritation or affecting the general system. 2. Saline cathartics, 
which increase both the peristaltic action of the bowels and the effusion 
of fluids from the mucous surface, but are devoid of any excitant 
action on the general system, and are therefore adapted to the treat- 
ment of febrile and inflammatory cases, or where, from any cause, it 
is desirable to deplete the vessels of the intestines by the abstraction 
of water. 3. Mild acrid cathartics ■, which are acrid, but not sufficiently 
violent in their local action to cause inflammation. 4. Hydragogues, 
comprising the more powerful and irritating cathartics, producing 
watery evacuations; in large doses, they act as acrid poisons. 5. 
Mercurial cathartics. 

Medicinal Uses. — Cathartics are employed — 1. To evacuate the 
bowels in constipation and remove noxious matters, as retained faces, 
undigested food, worms, poison, etc. 2. To depurate the blood, as in 
typhus fever, urcemia, etc. 3. To relieve inflammation, congestion and 
plethora, and lower blood-pressure, by the depletion of the blood- 
vessels; valuable in threatened apoplexy. 4. To promote absorption 



332 MATERIA MEDICA AND THERAPEUTICS. 

and remove fluid. 5. To affect remote organs, particularly the brain, 
through the agency of revulsion and counler-irritatioji. 6. To stimu- 
late the secretion of the liver and pancreas, by irritating the orifice of 
the ductus communis choledochus. 7. In the treatment of diarrhoea. 
8. To relieve hemorrhoids. 9. To restore the catamenia, by the irri- 
tating influence which they exert on the pelvic vessels. 

Contraindications. — The more active cathartics are contraindi- 
cated in cases of inflammation or ulceration of the gastro-intestinal 
mucous membrane, peritonitis, appendicitis, typhlitis, intussusception, 
the advanced stages of typhoid fever and pregnancy. 

The operation of cathartics is promoted by the addition of small 
doses of emetics and of the bitters. By combining those which act 
upon different portions of the alimentary canal, their operation is ren- 
dered less irritant, without any diminution of purgative efficiency. 
The griping and nauseating tendency of the hydragogue cathartics 
may be corrected by the addition of aromatics ; carbonic acid water is 
a grateful vehicle for administering the saline preparations. Cathar- 
tics operate most speedily and favorably when given on an empty 
stomach, and susceptibility to their action is diminished during sleep 
and increased by exercise. Mild diluent beverages promote their 
operation. In the event of hypercatharsis, opium should be adminis- 
tered by the mouth or the rectum. 

LAXATIVES. 

Several articles of diet have a laxative operation on the bowels, 
and are useful in cases of habitual costiveness, as most of the ripe and 
dried fruits — particularly the tamarind, peach, apple, raisin, fig (flcus), 
and prune {prunum) — West India molasses, honey, bran, cracked 
wheat, Indian meal, and oatmeal. 

The following medicinal substances are usually arranged under 
the head of laxatives and are employed in cases where we wish to 
open the bowels with the least possible irritation, — as in children and 
pregnant women, in inflammation or surgical operations about the 
abdomen and pelvis, in typhoid fever, hernia, piles, and affections of 
the rectum or womb. 

TAMARIN DUS— TAMARIN D. 

Description and Habitat. — This is the preserved pulp of the 
fruit of Tamarindus Indica {Nat. Ord. Leguminosae), a large tree of 
the East Indies, cultivated extensively also in the tropical portions of 
America. It comes to the United States chiefly from the West Indies. 



CATHARTICS -CASSIA FISTULA. 333 

The preserved pods, as found in the shops, consist of a dark-colored 
adhesive mass, formed of pulp, fragments of the pods, seeds and syrup, 
of a sweetish acidulous taste. 

Constituents. — They contain a good deal of citric acid, with 
some tartaric, a little malic acid, and glucose. 

Effects and Administration. — An infusion of the pulp sweet- 
ened, makes a refrigerant and laxative drink; Sss-j of the pulp is a 
good laxative. It is seldom used. It enters into the confection of 
senna. 

FICUS— FIG. 

The fleshy receptacle of Ficus carica {Nat. Ord. Urticacese) is 
mildly cathartic. It forms an ingredient of confection of senna. 

MANNA. 

Description and Habitat. — Manna is the concrete saccharine 
exudation, in flakes, of Fraxinus Ornus {Nat. Ord. Oleaceae), small 
trees of Sicily and Southern Italy. 

Preparation and Description. — It is obtained from incisions 
into the stems of the trees. The best kind is produced during the 
height of the season, when the juice flows vigorously, and from the 
upper stems, where it is less fatty. It is called flake-manna, or manna 
canulata, and consists of pieces from one to six inches long, one to 
two inches wide, and from half an inch to an inch thick, of irregular 
form, but more or less stalactitic, hollowed out on one side, of a white 
or yellowish-white color, an odor like that of honey, and a sweet, 
afterward rather acrid, taste. 

Chemical Constituents. — Manna is soluble in both water and 
alcohol, and contains a white crystalline, saccharine principle, termed 
ma7init (C 6 H u 6 ), not susceptible of the alcoholic fermentation, fraxin 
(C 3 2H 36 O 20 ), some sugar, and a resin to which it probably owes most of 
its purgative effect. 

Effects and Uses. — In moderate doses manna is nutritive ; in 
larger, mildly laxative. It is given principally to children in constipa- 
tion, to whom its sweet taste renders it acceptable ; and it is sometimes 
combined with the more active cathartics. 

Administration. — Dose for an adult, Sj-iij ; for children, 5j-iij. 
It may be taken in substance, or dissolved in warm milk or water. 

cassia fistula— purging cassia. 
Description, Habitat and Properties. — This is the fruit of 



334 MATERIA MEDICA AND THERAPEUTICS. 

Cassia Fistula or Purging Cassia {Nat. Ord. Leguminosae), a large 
tree of Egypt and the East Indies, now naturalized in the West Indies 
and South America. It consists of. long, woody, dark-brown pods, 
about an inch in diameter and nearly two feet in length, which con- 
tain numerous seeds imbedded in a soft, black pulp. The pulp is the 
part used, and has a faint nauseous odor and a sweet, rather pleasant, 
mucilaginous taste. 

Effects and Uses. — It is, in small doses, a mild, agreeable laxa- 
tive, but its chief use is as an ingredient in the confection of senna. 

Administration. — Dose, 5j to 5j. 

Oleum Olivae {Olive-Oil). — The well-known fixed oil obtained 
from the fruit of Olea europsea, or Olive Tree {Nat. Ord. Oleaceae), 
is nutritive, demulcent, emollient, and laxative. It is prescribed as a 
constituent of laxative enemata. It is also used as an inunction in 
measles, erysipelas, and scarlet fever, and to remove by softening the 
crusts and scales of certain skin-affections. As a lubricant it is 
smeared on instruments before introduction to mucous cavities. It is 
now known that carbolized olive-oil is inert as far as antisepsis is 
concerned. 

Oleum Amygdalae Expressum {Expressed Oil of Almond), a fixed oil 
expressed from the Sweet or Bitter Almond, is used for the same pur- 
poses as olive-oil. 

OLEUM RICINI— CASTOR OIL. 

Description and Habitat. — Castor-oil is the fixed oil obtained 
from the seed of Ricinus communis, or Palma Christi (Nat. Ord. Eu- 
phorbiaceae), a small perennial tree of India, now naturalized in many 
warm climates, and cultivated extensively in the United States. In 
India it attains a height of thirty or forty feet, but in this country it is 
an annual plant, about five or six feet in height, with round, thick- 
jointed, furrowed stems, of a purplish color above ; large peltato- 
palmate leaves, divided into seven or nine segments, on long round 
footstalks, and prickly, three-celled capsules, with a seed in each 
cell. 

Properties. — The seeds are ovate, about the size of a small bean, 
and of a gray color, marbled with reddish-brown spots and stripes. 
They consist of a thin outer pellicle, an inner hard, blackish shell — 
both of which are inert — and a white oleaginous kernel, which contains 
the acrid principle. 

Preparation and Chemical Constituents. — Castor-oil is ob- 
tained by expression, by decoction, and by the agency of alcohol. 



CATHARTICS— CASTOR OIL, 
Fig. 32. 



385 




CASTOR-OIL PLANT. 



Fig. 33. 




x. Castor-Oil Capsule. 

2. Section of Capsule Showing Seeds. 



336 MATERIA MEDIC A AND THERAPEUTICS. 

The first method is the best, and is that which is pursued in this 
country, where large quantities are made, both for home consumption 
and exportation ; heat should not be employed in preparing it, as it 
renders it rancid. Thus procured, it is nearly colorless, or of a pale- 
yellow color, of a thick, viscid consistence, a faint, unpleasant odor, a 
disagreeable taste, and becomes rancid and thick by exposure to the 
air. It is not soluble in water, but is extremely soluble in alcohol, 
readily so in ether, and forms soaps with the alkalies. Its composition 
is not well understood; its constituents would seem to be mainly 
ricinolein (a saponifiable oil resembling olein), ricinic acid, palmitin, 
and an acrid principle. An analysis of the stem, root and leaves by 
Beck* yielded volatile oil (non-saponifiable), wax, resin, alkalies, and 
an alkaloid termed ricinine (C 24 H 32 N 7 3 ), identical with the alkaloid 
obtained by Tuson from the seed, and with the substance extracted 
by Wayne,f from the leaves. The latter denies its claim to being 
called an alkaloid. 

Toxicology. — The kernels possess considerable acridity, and in 
large quantities have produced death— the usual symptoms being 
vomiting and purging — and Taylor % records a case in which the 
eating of twenty of the seeds killed a girl. Christison § states that 
the seeds will operate as a violent cathartic. Dr. Edson || has, how- 
ever, recently reported sixteen cases of non-fatal poisoning following 
the ingestion of the bean, in none of which did catharsis occur. In 
each instance it was thought three or four were eaten. 

Effects and Uses. — Its taste is mild and nauseous. Castor oil 
is a mild and tolerably certain laxative in constipation, operating, when 
pure, in from four to six hours after its administration, without uneasi- 
ness in the bowels. It does not stimulate the liver nor increase the 
secretion of bile, but purges by a mild irritant action on the intestines 
(Rutherford \). It is admirably adapted to all cases where a free 
evacuation of the bowels is desired, without abdominal irritation, as 
in acute dysentery, biliary calculi, pregnancy, typhoid fever, cholera 
infantum, intestinal colic, enteritis, hemorrhoids , proctitis, yellow fever, 
peritonitis, etc., and is an excellent purgative for children. In cholera 

* Am. Journ. of Pharmacy, Feb. 1888, p. 93. "Analysis of Ricinus Communis." 

| Ibid., 1874, p. 97. 

J Manual of Med. Jurisprudence, p. 224. 

\ " A Treatise on Poisons," 4th ed., p. 590. 

|| Brooklyn Med.Joum., Feb., 1888, p. 131. 

fl " Phys. Action of Drugs on Secretion of Bile." 1880. 



CA THAR TICS—SULPHUR. 337 

morbus and diarrhoea due to the indigestion of unripe fruit, great benefit 
is often derived from an emulsion of oil with laudanum: B^ Tincturae 
opii, f 5j ; olei ricini, f Sjss ; pulveris acaciae, 5'j ; sacchari albi, §ss ; 
aquae cinnamomi, q. s. ad f giij. M. et Sig. — Shake the bottle and take 
two teaspoonfuls every four hours. A similar prescription, modified 
according to age, will be found of service in the summer diarrhoeas of 
children. The leaves are said to possess galactagogue properties, and 
are applied to the breasts, in the form of decoction or poultice, to 
induce the secretion of milk. 

Administration. — For adults the dose is fgss-j ; for children, 
f 5i-f5ss. To cover its unpleasant flavor it may be made into an 
emulsion, as follows: 3^ 01. ricini, f§j; pul. acaciae, 5ij; ol. cinna- 
niomi (vel anisi), TTLiij— v ; aquae ad f§ij. M. S. — One dose; or it can 
be had in capsules of Tfl, 45 each. 

Linseed Oil (oleum lint) is laxative in the same doses as castor oil. 

SULPHUR. 

Source. — Sulphur exists in both kingdoms of nature. It is pro- 
cured by the purification of native sulphur and by the decomposition 
of the native sulphides. The sulphur of commerce is generally 
obtained in the former way, chiefly from Sicily, and is termed crude 
sulphur. It comes also from Romagna, in Italy, and from California, 
and considerable deposits of sulphur have been found in the Island of 
Saba, one of the Dutch West Indies, and in Japan. 

Preparation. — After importation it is purified by sublimation, and 
is known as sublimed sulphur — sulphur sublimatum. It is sometimes 
sublimed in the form of an impalpable powder, when it is called the 
flowers of sulphur. Sometimes it is cast in wooden moulds, and forms 
the roll-sulphur, or brimstone of commerce. Sublimed sulphur con- 
tains more or less sulphuric acid, and for medicinal use it is further 
purified by washing, when it constitutes washed sulphur or sulphur 
lotum of the Pharmacopoeia. 

Description. — As met with in the shops, it is a fine, bright-yellow 
powder, with a feeble odor and taste, insoluble in water and in alcohol, 
but soluble in alkaline solutions, and the oils ; and when perfectly pure 
it is wholly volatilized by heat, and ought not to change the color of 
litmus-paper. 

Physiological Effects. — Locally, sulphur is antiseptic, and des- 
troys the itch- and other parasites. Sublimed sulphur has a faintly 
acid taste, washed sulphur none. In small and repeated doses sulphur 
22 



338 MATERIA MEDICA AND THERAPEUTICS. 

is a gentle stimulant to the skin and mucous membranes, and in larger 
doses it acts as a mild purgative, without exciting the pulse or occa- 
sioning griping. It is probably absorbed on being converted in the 
small intestine, by the alkali of the bile, into a sulphide. After its 
continued use the intestinal gases give off sulphuretted hydrogen. 
Elimination : chiefly as sulphates. Though not classed among the 
poisons, yet in large amounts (Siij) it will produce violent vomiting 
and purging, raise the temperature, and impart to the breath the odor 
of sulphuretted hydrogen. 

Medicinal Uses. — It is employed in the cases to which laxatives 
are applicable, and also as an alterative- diaphoretic in chronic cutaneous 
diseases, and in rheumatism. It is considered a specially useful laxative 
in hemorrhoids. To increase its cathartic effect it is often combined 
with cream of tartar or magnesia. Topically, it is a valuable remedy 
in various skin diseases, particularly the scaly and parasitic, as scabies, 
psoriasis, phthiriasis ■, favus ; tinea, and sycosis. In psoriasis, if the scales 
be plentiful, they should be removed with green soap and warm water; 
in favus the hair is to be closely cropped and the crusts removed with 
poultices ; the same preparatory treatment is required for sycosis. The 
strength may be 5j-iv to the Sj of ointment. Before its application in 
scabies the patient should thoroughly wash the part with hot water 
and soft soap. It is also used in acne in the form of ointment. With 
camphor gr. v-xv, sulphur 5^-j, in ointment Sj, it makes a useful 
stimulant application in acne. 

As a Disinfectant. — Sulphur, when ignited, unites with the 
oxygen of the air to form sulphur dioxide (S0 2 ). In this state it is 
powerfully germicidal against certain atmospheric microbes, viz.: those 
of typhoid fever, tuberculosis, cholera, and diphtheria (Thinot), as 
has been recently shown in some clever experiments by Dubief and 
Gaillard.* Moisture considerably enhances its germicidal powers, 
doubtlessly due to H 2 S0 3 . For the purpose of disinfecting a contam- 
inated apartment about 5j per cubic yard should be ignited in earthen 
saucers ; all the openings should be tightly closed, and the process 
kept up 24 hours (Dujardin-Beaumetzf)- To facilitate the burning 
Pasteur suggests the addition of a little alcohol, and to prevent the 
tarnishing of metal-work vaseline should be smeared over it. By 
fumigating an infected bed, the bedbugs can be destroyed. 



* Bull. Gen. de Therap., Aout 30, 1889, p. 175. 
I Therap. Gazette, Feb. 15, 1889, p. 73. 



CA THAR TICS— SULPHUR. 339 

Administration. — Dose, 5j-iij or iv, in syrup (5i in syrup, or 
molasses f§j) ; or in capsules. Pulvis glycyrrhizce compositus contains 
sulphur (see Senna). Topically, it is applied in the form of vapor bath 
or ointment. Unguentum sulphuris consists of 30 parts of washed sul- 
phur and 70 parts of benzoinated lard rubbed together until thoroughly 
mixed. Sulphur can be exhibited in the form of soap. 

Sulphur Prsecipitatum (Precipitated Sulphur, or Lac Sulphuris} is 
prepared by boiling together sulphur, slaked lime and water and after- 
ward precipitating the sulphur by hydrochloric acid. It is a finer and 
softer powder than sublimed sulphur, is of a paler yellow color, with 
a grayish tint, and is without odor or taste. When exposed to the air, 
however, it is liable to become contaminated* with sulphuric acid, and 
as found in commerce, it is often adulterated with calcium sulphate. 
Its effects, uses, and doses are the same as those of sublimed sulphur. 

Potassa Sulphurata {Sulphurated Potassa), or Liver of Sulphur, is 
prepared by rubbing together one part of sublimed sulphur with two 
parts of potassium carbonate, afterward melting the mixture, and pour- 
ing it when cold into a bottle. Its composition is variable and uncer- 
tain, but it should contain about 50 per cent, of potassium sulphide. 
When freshly and carefully prepared it is of a liver color, has an 
acrid, alkaline, disagreeable taste, and forms an orange-yellow solution 
with water. 

Effects and Uses. — This preparation and the other sulphides 
probably act like sulphur. They are, perhaps, in part decomposed by 
the acids of the stomach, but any liberated sulphur must be again 
combined with the alkali of the bile. 

Toxicology. — Taken in large quantities sulphurated potassa is a 
corrosive poison, capable of producing fatal gastro-enteric inflamma- 
tion. Three cases of poisoning are reported from it by Orfila,* in one 
of which 5iij proved fatal. 

Medicinal Uses. — Locally, potassa sulphurata is parasiticidal. 
The sulphides are considered to be expectorant, diaphoretic, and altera- 
tive. They have been especially recommended in the scrofulous abscesses 
of children — the calcium sulphide being preferred. 

Administration. — Dose, for an adult, gr. ij-x, several times a 
day. They are used topically in scaly skin-diseases {plithiriasis and 
psoriasis) in the form of ointment (5ss to §j of lard), and of baths. 

* " Toxicologic Generate, " Vol. I, p. 177. 



340 MATERIA MEDICA AND THERAPEUTICS. 

SULPHUR-WATERS— NORTH AMERICAN. 

Note. — The therapeutical value of all sulphur-waters, as far as the 
sulphur is concerned, depends on the presence of the sulphur combined 
with hydrogen as sulphuretted hydrogen. This gas is very destructive 
to plant life. Upon mammals by inhalation it produces asphyxia, con- 
vulsions and death. After death the haemoglobin of the blood is found 
to be decomposed. Sulphuretted hydrogen is mostly generated in 
cess-pools. The quantity of H 2 S gas taken into the system by the 
stomach in the form of sulphur-waters is so small as to produce no 
obvious effect on the blood. 

Blount Springs (Blount County, Alabama). — This water, analyzed 
by Prof. R. Brumby, contains magnesium, calcium, and iron carbonates, 
sodium chloride, with carbonic acid and sulphuretted hydrogen. It 
is a saline sulphur-water. 

Alpena Well {Alpena County, Michigan). — Contains the alkaline, 
earthy, and iron carbonates with an abundance of sulphuretted hydrogen- 
Sharon Springs (Schoharie County, New York). — These waters con- 
tain sodium, magnesium and calcium chlorides, the alkaline and earthy 
carbonates, and in small proportion sodium and calcium sulphides and 
sulphuretted hydrogen. 

Richfield Springs (Otsego County, New York). — Prof. Reid's analysis 
shows these waters to contain magnesium and lime carbonates, Epsom 
salt, calcium sulphate, and sulphuretted hydrogen. May be taken two 
to four glasses daily; also as baths. 

Minnequa Springs (Bradford County, Pennsylvania). — Contains 
sodium, magnesium, and lime carbonates, iron oxide and an undeter- 
mined quantity of sulphuretted hydrogen. It is a chalybeate sulphur- 
water. 

Jordan's White Sulphur Springs (Frederick County ', Virginia). — 
They contain the earthy, alkaline, and iron carbonates in small pro- 
portion with sulphuretted hydrogen. May be taken freely. 

Greenbrier White Sulphur Springs (Greenbrier County, West Vir- 
ginia). — They contain the earthy and alkaline carbonates and chlo- 
rides, Epsom salt, calcium sulphate, silicates, and the following gases : 
carbonic acid, sulphuretted hydrogen, oxygen and nitrogen. An 
excellent aperient alterative water with a diuretic action. 

SULPHUR-WATERS— EURO PEAN. 

Aix-la-Chapeiie (Rhenish Prussia). — Analyzed by Liebig ; temper- 
ature 1 31° Fahr. Contains the alkaline, earthy and iron carbonates, 



SALINE CATHARTICS. 341 

sodium chloride in considerable quantity, Glauber's salt, sodium iodide 
and bromide, with carbonic acid, sulphuretted hydrogen, and nitrogen 
gases. The Nenndorf and Meinberg wells are very similar in com- 
position, but in temperature they are about 8o° lower. The waters 
possess an alkaline, saline and sulphurous taste, and are diaphoretic 
and diuretic. 

Aix-les-Bains {Savoy). — Analyzed by Bonjean. The eau de soufre 
has a temp, of 108-11 Fahr., contains the alkaline, earthy, and iron 
carbonates with traces of the sulphates, and carbonic acid, nitrogen, 
and sulphuretted hydrogen gases. They are employed mostly as 
baths. The springs at Bareges, and Bagneres de Luchon, in France, 
are very similar in composition except as to temperature, the former 
being 64 ° Fahr., the latter 13 1° Fahr. 

Medicinal Uses. — The characteristic of the sulphur waters is the 
odor of sulphuretted hydrogen. The composition and effects vary 
according to the preponderance of certain ingredients. Those that 
contain a goodly proportion of common salt are termed saline-sul- 
phur ; when they have a large quantity of calcic salts they are con- 
stipating. Some are sedative, others exciting, particularly those of 
high temperature. They all are diaphoretic and diuretic. These 
waters are prescribed internally and externally in various cutaneous 
affections, as chronic eczema, lichen, psoriasis, phthiriasis, and syphilitic 
eruptions. The warm sulphur baths are beneficial in gout and chronic 
rheumatism, colica Pictomim, hepatic engorgement, and hemorrhoids. 

SALINE CATHARTICS. 

Before considering in detail the precise action on the alimentary 
tract of the saline cathartics, a brief argument will be offered relating 
to the opinions and work of the investigators who have experimented 
physiologically with these substances. There has been much con- 
troversy between numerous investigators as to their exact method of 
action upon the intestinal canal, the question being this : Do they 
effect catharsis, by inciting peristalsis ; or is it due to an increased dis- 
charge of fluids ? Considerable practical evidence has been brought 
forward by Thiry and Radziejewsky to prove that cathartic drugs* 
especially the hydragogues, operate by arousing peristalsis, but their 
work, though apparently accurate, lacks the confirmation of observers 
whose results cannot be impugned, and, moreover, the latter have much 
clinical evidence to substantiate their side of the question. Among 
those who have devoted much time and labor in the laboratory to the 



342 MATERIA MEDICA AND THERAPEUTICS. 

elucidation of the action of the salines are Lauder Brunton,* Anstie,f 
Moreau.J Matthew Hay,§ and Vulpian.|| The work of Hay, with 
which we agree, is most elaborate, being a model of research. Con- 
cisely stated, all of these observers are unanimously of the opinion 
that catharsis is induced chiefly by augmented intestinal secretion, and 
they offer many incontrovertible facts to substantiate their opinions. 
We quote some of Hay's conclusions : 

"A saline purgative always excites more or less secretion from 
the alimentary canal, depending on the amount of the salt and the 
strength of its solution, and varying with the nature of the salt. The 
excito-secretory action of the salt is probably due to the bitterness as 
well as to the irritant and specific properties of the salt, and not to 
osmosis. The low diffusibility of the salt impedes the absorption of 
the secreted fluid. Purgation will not ensue if water be withheld from 
the diet for one or two days previous to the administration of the salt 
in a concentrated form. Cceteris paribus, the weaker, or, in other 
words, the more voluminous the solution of the salt administered is, 
the more quickly is the maximum within the canal reached, and 
accordingly purgation follows with greater rapidity." 

" The salt excites an active secretion in the intestines, and prob- 
ably for the most part in the small intestine, all portions of this viscus 
being capable of yielding the secretion in almost equal quantities. 
The bile and pancreatic juice participate but very little in the secre- 
tion. The salt does not purge when injected into the blood, and 
excites no intestinal secretion. Nor does it purge when injected sub- 
cutaneously, unless in virtue of its causing local irritation of the 
subcutaneous tissue, which acts reflexly on the intestines, dilating 
their blood-vessels, and perhaps stimulating their muscular move- 
ments. The sulphate of soda exhibits no poisonous action when 
injected into the circulation. The sulphate of magnesia is, on the 
other hand, powerfully toxic when so injected, paralyzing first the 
respiration and afterward the heart. Both salts, when administered in 



* Practitioner , Vol. xn, pp. 342 and 403. " On the Actions of Purgative Medicines." 

■f Med. Times and Gazette, Vol. I, pp. 326 and 487. ''Report on the Action of 
Podophyllin." 

%Arch. Gen. de Med., XVI, dttme S er., p. 234. " L' action du sulphate de magnesie 
sur l'intestin." 

IJourn. of Anat. and Phys., Vol. XVI, pp. 343, 391; Vol. XVII, pp. 62, 223, 465. 
"The Action of Saline Cathartics." 

II Gazette Medicate de Paris, 1873, P- 3°°- 



CATHARTICS— MAGNESIUM CARBONATE. 343 

the usual manner, produce a gradual but well marked increase in the 
tension of the pulse. The blood recoups itself in a short time by- 
absorbing from the tissues a nearly equal quantity of their fluids. The 
salt after some time causes diuresis. The amount of the normal con- 
stituents of the urine is not affected by the salt. The salt has no 
specific action in lowering the internal temperature of the body." 

Lauder Brunton (loc. cit.) differs from Hay's (loc. cit.) conclusions 
in that he found that purgatives reduced the arterial pressure, as 
shown by the sphygmograph. 

Clinically, the results of these observers are supported by the fact 
that watery stools are characteristic of the exhibition of the salines in 
sufficient doses. 

MAGNESIA— MAGNESIA. 
MAGNESIA PON DEROSA— HEAVY MAGNESIA. 

Preparation. — Magnesia (MgO), sometimes called calcined or 
light magnesia, from the mode in which it is prepared, is procured by 
exposing magnesium carbonate to a red heat, till the carbonic acid is 
wholly expelled. 

Properties. — It is a light, fine, white, colorless, odorless powder, 
of a feeble, earthy taste, very slightly soluble in water, and more 
soluble in cold than in hot water. Heavy magnesia is a white, fine, 
dense powder, chemically identical with magnesia, and differing from 
it only in the degree of aggregation of its molecules. 

Effects and Uses. — Magnesia is antacid and laxative. A good 
deal of its cathartic effect is in part the result of its combination with 
the free acids of the stomach and intestines, but also of the excretion 
and pouring out of fluid into the intestines. When taken in large 
quantities, and for too long a period, it sometimes accumulates in the 
bowels ; and hence it is best to increase its solubility by giving it with 
lemonade. It is an excellent laxative in constipation where much 
acidity exists in the stomach, and is particularly useful in infantile 
cases. As an antacid and laxative it is employed in heartburn, 
migraine, biliousness and duodenal catarrh. 

Administration. — Dose, as a laxative, 5j ; as an antacid, gr. xx, 
in water or milk. 

MAGNESII CARBONAS— MAGNESIUM CARBONATE. 

Preparation. — Magnesium carbonate, sometimes called magnesia 
alba, is prepared by decomposing magnesium sulphate with an alkaline 
carbonate. As found in the shops it is a combination of magnesium 
carbonate and magnesium hydrate (MgCo 3 ) 4 .Mg(HO) 2 +5H 2 0. 



344 MATERIA MEDICA AND THERAPEUTICS. 

Properties. — It occurs in the form of light, white, cubical cakes 
or powder; is inodorous, almost insipid, and nearly insoluble in water, 
but soluble in carbonic acid water. 

Effects and Uses. — These are nearly the same as those of cal- 
cined magnesia; but from its effervescence with the acids of the 
stomach, it is apt to create flatulence, though sometimes, on this 
account, it is more acceptable to delicate stomachs. 

Administration. — Dose, as a laxative, 5j-ij ; as an antacid, gr. x. 
It may be had in the shops in small blocks for desiccant purposes. 

MAGNESII SULPHAS— MAGNESIUM SULPHATE. 

Source. — This salt (MgS0 4 +7H 2 0), commonly called Epsom Salt, 
from its having been first procured from the Epsom mineral water in 
England, occurs in native crystals, and is a constituent of sea-water 
and many saline springs. 

Properties. — It is usually met with in small acicular crystals, 
which are colorless, transparent and odorless, but have an extremely 
bitter taste. They effloresce on exposure to the air, are very soluble 
in water, and insoluble in alcohol. 

Effects and Uses. — Epsom salt is a mild, safe, refrigerant pur- 
gative, which, from its cheapness, is by far the most commonly em- 
ployed of all cathartics. It produces free, watery purgation, with very 
little irritation of the intestines, stimulating the intestinal glands, but 
not affecting the liver. By reason of these effects it is very serviceable 
in conditions of constipation, congestion, inflammation, proctitis, cerebral 
hyperemia, cerebrospinal meningitis, and as a galactafuge. Free pur- 
gation is indicated to relieve the bleeding of hcemoptysis, if protracted. 

Matthew Hay* has called attention to the efficacy of concentrated 
saline cathartics for the removal of dropsical effusions, as in hydrothorax, 
pericarditis, chronic Bright 's disease, etc. He states that they concen- 
trate the blood, increase the proportion of red globules, and produce 
watery stools. He used of Epsom salt S^ to water f5j. Osier f re- 
ports favorable results with Hay's method in diminishing pleuritic effu- 
sions. He employed 5iv-vj to water Sj. The stomach should be 
empty at the time of administration, and the patient should not drink 
for some time afterward. In the treatment of colica Pictonum and the 
cachexia resulting from chronic lead-poisoning, this salt, combined with 
diluted sulphuric acid, is of the greatest service. It is also used in 

* Lancet, April, 1883, p. 678. f The Med. News, Dec, 1886. p. 645. 



CATHARTICS— SODIUM SULPHATE. 345 

combination with opium in acute dysentery, but is inferior to Rochelle 
salts in the treatment of this complaint. It is sometimes combined 
with senna, sometimes with bitter infusions, and is most agreeably 
administered in solution in carbonic acid water. 

Administration. — Dose, Sss-j, either in water alone or with 
compound infusion of gentian. 

LIQUOR MAGNESII CITRATIS— SOLUTION OF MAGNESIUM CITRATE. 

Preparation and Properties. — Under this name magnesium 
citrate is employed in solution, with slight excess of acid, and in the 
effervescing state. It is prepared according to the following formula : 
citric acid, 30 grammes are dissolved in water 120 Cc, and in this solu- 
tion magnesium carbonate 15 grammes are stirred until dissolved; 
this solution is filtered into a strong 360 Cc. bottle, containing syrup of 
citric acid, 120 Cc. ; to this is added water, previously boiled and 
filtered enough to nearly fill the bottle; potassium bicarbonate 2.5 
grammes are then dropped in and the bottle is immediately closed 
with a cork, and secured with twine ; the mixture must be occasionally 
shaken to insure the solution of the bicarbonate. The effervescing so- 
lution has a pleasant acid taste, without anything disagreeable. 

Effects and Uses. — It is a very grateful cathartic, and is much 
employed in constipation, as a substitute for Epsom salt, but is more 
apt to produce slight griping. Dose, from a half to a whole bottle. 

Magnesii Citras Effervescens {Effervescent Magnesium Citrate) is a 
white, coarsely-granular salt, deliquescent on exposure to air, odorless, 
having a mildly acidulous, refreshing taste, and an acid reaction. 
Soluble with copious effervescence in two parts of water ; almost in- 
soluble in alcohol. It should be kept in closely-stoppered bottles. 
Its effects are similar to those of the solution, and it is used for the 
same purpose. It has the advantage of portability. Dose, 5j-iv dis- 
solved in water and taken while effervescing. 

SODII SULPHAS— SODIUM SULPHATE. 

Preparation. — Sodium sulphate, commonly called Glauber's Salt 
(Na 2 S0 4 +ioH 2 0), is a constituent of many mineral springs, and is 
prepared in various chemical processes. It occurs as a residuum in 
the manufacture of hydrochloric acid, made by adding sulphuric acid 
to sodium chloride, and it is obtained from sea-water in the winter 
season. 

Properties. — It is found in colorless, six-sided, very efflorescent 



346 MATERIA MEDICA AND THERAPEUTICS. 

crystals, which are inodorous, but have a cooling, saline, very bitter 
taste. It is soluble in water, more readily in hot than cold water, 
and is insoluble in alcohol. 

Effects and Uses. — These are very similar to those of Epsom 
salt, but it is more bitter and nauseous, and is now little used. It 
is a mild hepatic stimulant, according to the experiments of Ruther- 
ford on dogs. The effects of the sodium salts have already been con- 
sidered {vide index). It has an antiplastic action on the blood, due to 
the sodium which it contains. 

Administration. — Dose, gj ; in an effloresced state, §ss. 

MANGANI SULPHAS— MANGANESE SULPHATE. 

Preparation. — This salt (MnS0 4 +4H 2 0) is made by heating the 
native black oxide with concentrated sulphuric acid. 

Properties. — It occurs in rhombic, prismatic crystals, of a pale- 
rose or pink color, transparent, and of an astringent and bitterish taste. 
It is very soluble in water, insoluble in alcohol. 

Effects and Uses. — These are said to resemble Glauber s Salt, 
acting also as a cholagogue. 

Administration. — Dose, as a purgative, 5j-ij, in water and aro- 
matic elixir. 

SODII PHOSPHAS— SODIUM PHOSPHATE. 

Preparation. — This salt is prepared by digesting burnt bone with 
diluted sulphuric acid, and decomposing the resulting monocalcic 
phosphate with sodium carbonate. 

Properties. — It is disodic phosphate, and occurs in large rhombic, 
colorless, transparent, very efflorescent crystals (Na 2 HP0 4 -f I2H 2 0), 
which are wholly soluble in water and insoluble in alcohol, and have a 
pleasant saline taste, resembling common salt. 

Incompatibles. — With the alkaloids which it precipitates. 

Effects and Uses. — Sodium phosphate is a mild saline cathartic, 
well adapted, from its agreeable taste, to the cases of children and 
delicate persons. It is an hepatic stimulant, increasing the amount of 
bile secreted, although making it more watery, and having a very 
slight irritant action on the intestinal mucous membrane (Rutherford). 
It increases the alkalinity of the blood and diminishes the amount of 
urea excreted. It is a constituent of the blood in health, and has been 
recommended to repair the drain on the system, in diseases where 
there is a deficiency of phosphatic matter in the bones, as in rickets. 
In all catarrhal conditions of the gastro-intestinal mucous membrane, 



CA THARTICS—PO TASSIUM BITARTRA TE. 347 

notably in catarrhal jaundice, sodium phosphate is of the greatest 
utility, and it is one of the agents used to promote the solution or 
hinder the formation of biliary calculi in the dose of 5j t. d. in water, 
taken before meals and continued several weeks. It is highly recom- 
mended also in chronic infantile diarrhoea with pasty stools (Routh). 
Dr. Peters * advises the employment of sodium phosphate in chronic 
rheumatism for the reasons, that, in addition to its laxative action, it 
lessens the gastro-intestinal acidity, and makes the blood, urine, and 
perspiration more alkaline. 

Administration. — Dose, as a cathartic, 5yj, in cinnamon-water. 
As an alterative, gr. xx-5j, three or four times a day. 

Sodii Pyrophosphas [Sodium Pyrophosphate) (Na 4 P 2 7 +ioH 2 0) oc- 
curs in colorless, translucent prisms, odorless, but having a cooling, 
saline taste, and a slightly alkaline reaction, and perfectly soluble in 
water. The effects and uses are said to resemble those of sodium 
phosphate. Dose, 5ss-iv, in aqua gaultheriae. 

POTASSII SULPHAS— POTASSIUM SULPHATE. 

Preparation. — This salt exists in both kingdoms of nature, and 
is obtained artificially from the residuum of the distillation of nitric 
acid from potassium nitrate and sulphuric acid. 

Properties. — It occurs in small, hard, colorless, inodorous crys- 
tals (K 2 S0 4 ), of a saline, bitter taste, which have no water of crystalli- 
zation, and are unalterable in the air. They are moderately soluble in 
water, and are insoluble in alcohol. 

Effects and Uses. — The physiological effects of the potassium 
salts have already been fully considered (vide p. 253). In small doses 
it is considered a mild and safe cathartic ; but in large doses has proved 
a violent and even fatal poison, producing symptoms of cholera. 

Administration. — Dose, as a cathartic, gr. xv-5j-ij ; but it is 
little employed in this country. From its hardness and dryness it is 
useful to promote the trituration and division of powders. 

potassii bitartras-potassium bitartrate. 
Source. — This salt, well known as Cream of Tartar, and termed 
also acid potassium tartrate, is the monopotassic tartrate (KHQH 4 6 ). 
It exists in many vegetable juices, particularly the juice of grapes, from 
which it is obtained. 

* N. Y. Med. Record, Jan. 23, 1886. 



348 MATERIA ME DIG A AND THERAPEUTICS. 

Preparation and Properties. — It is deposited in an impure form, 
during fermentation, on the sides of wine-casks, and in this state occurs 
in crystalline cakes, of a reddish color, known as argol or crude tartar. 
This is purified by solution and crystallization, and forms a white crys- 
talline mass or powder, termed cream of tartar. It is without smell, 
has an acidulous and gritty taste, is very slightly soluble in water, and 
insoluble in alcohol ; when heated in a close vessel, it is converted 
into black flux, a compound of charcoal and potassium carbonate. 

Effects and Uses. — In small doses it is diuretic and refrigerant ; 
in larger doses, cathartic ; and in excessive doses it will produce gas- 
trointestinal inflammation. It is employed to form a refrigerant 
drink, and as a gentle aperient in fevers ; as a diuretic and hydra- 
gogue cathartic in general dropsy depending on valvular disease of the 
heart, and in acute Bright 's disease. 

Administration. — Dose, as an aperient, 5ss-j ; as a cathartic, 
5ss-j ; as a diuretic, gr. x— 5j, in repeated doses ; dispensed in powder. 
It enters into the compound powder of jalap. 

POTASSII ET SODII TARTRAS— POTASSIUM AND SODIUM TARTRATE. 

Preparation. — This salt (KNaC 4 H 4 6 +4H 2 0), commonly called 
Rochelle Salt, is made by saturating the excess of acid in cream of 
tartar with sodium carbonate. 

Properties. — It occurs in large, transparent, colorless, prismatic, 
slightly efflorescent crystals, of a mildly saline and bitter taste, readily 
soluble in cold water, and still more so in hot water. 

Effects and Uses. — It is the best saline for use in the treatment 
of acute dysentery, combined with opium and given in small doses fre- 
quently repeated until oj has been taken in the first 24 hours, after 
which the dose is decreased ; ^ Potassii et sodii tartratis, 5j ; tincturae 
opii, TTL x ; aquae, f §ss. M. S. — Every two hours. It is a mild and 
pleasant aperient, well adapted to gouty cases and cases of uric acid 
diathesis, but it renders the urine alkaline, and should not therefore be 
given to persons suffering with phosphatic deposits in the urine. 

Administration. — Dose, 5ss-j, in water. It is usually exhibited 
in the form of pulvis cffervcscens co nip o situs (compound effervescing 
powder) or Scidlitz powder, which consists of Rochelle salt (93 parts) 
and sodium bicarbonate (31 parts) in a blue paper, and tartaric acid 
(27 parts) in a white paper. They are taken, dissolved in half a pint 
of water, while the liquid is in a state of effervescence, and form an 
agreeable and efficient mild aperient in biliousness, migraine, etc., and 



CATHARTICS— SALINE MINERAL WATERS. 349 

are very acceptable to the stomach. They should not be kept in a 
damp place. 

SALINE MINERAL WATERS— NORTH AMERICAN. 

St. Catharine's Wells (Si Catharine's, Ontario, Canada). — Analysis 
of Stephenson House Well by Prof. Croft : one pint contains potas- 
sium chloride, gr. 2.587; sodium chloride, 217.234; magnesium chlo- 
ride, 24.760; calcium chloride, 108.271 ; ammonium chloride and sil- 
icic acid, 0.056; calcium sulphate, 15.981; magnesium iodide, 0.030- 
magnesium bromide, 0.045 J temperature, 6o° F. For internal use 
they must be diluted %-% with ordinary water. They are employed 
also in the form of water-baths. These waters have been found bene- 
ficial and curative in chronic rheumatism, gout and scrofula. 

Michigan Congress Spring (Ingham County, Michigan). — Analysis 
by Dr. Jennings :"one pint contains sodium carbonate, gr. 8.094; mag- 
nesium carbonate, 1.421 ; iron carbonate, 0.143 ; lime carbonate, 7.782; 
sodium chloride, 33.349; potassium sulphate, 1.554; sodium sulphate, 
3. 131; silica, O.413 ; carbonic acid gas, 24^ cubic inches; tempera- 
ture, 53^2° F- An alkaline-saline water, decidedly purgative in char- 
acter ; in moderate quantities is only diuretic. It is applicable to the 
treatment of dyspepsia with plethora, obesity, chronic hepatitis and bil- 
iary calculi. 

Saratoga Waters. — From the analysis of these waters (see table) 
it will be seen that they consist chiefly of sodium chloride and the 
alkaline carbonates. Containing so large a proportion of alkali, they 
may be termed alkaline-saline waters. Besides this they are highly 
impregnated with carbonic acid gas, rendering them palatable and 
easy of digestion. Their use is adapted to cases of dyspepsia depend- 
ing on high living, and an engorged condition of the liver ; in acidity, 
also in jaundice, due to catarrh of the biliary ducts. Since these 
waters contain the salines in abundance they are of a purgative nature, 
and hence may be useful in habitual constipation, obesity and' plethora 
of the abdominal viscera. As most of them have a small proportion 
of lithium carbonate, particularly the Pavilion Spring, they often prove 
beneficial in gout and the gouty diathesis. The Columbian, Hamilton, 
Excelsior and Eureka Springs contain iron carbonate (about gr. ^ to 
the pint), and are consequently adapted to ancemic cases ; they are to 
be drunk cautiously by the plethoric. The dose of the Saratoga 
waters is, as a cathartic, two or three glasses taken leisurely before 
breakfast ; then a walk of ten or fifteen minutes and another glass or 
two ; breakfast half an hour later. As an alterative one glass three 



350 



MATERIA MEDICA AND THERAPEUTICS. 



or four times daily. The waters of the springs that contain iron 
should be taken one-quarter to one glass per diem. 



Analysis of Saratoga Springs ; Saratoga County, New York. 




& 


u u 


£ 




u u 


• 




u 




•3 


•B 


-3 


T3 


Q 


t/i^ 


T3 


_i> 


M\ 





Q 


Q 


t3 




A .S 


c 


. rt 


C 


oS 


a « 


C 


a 


• «i £» 


s 


u% 


; S 


. rt 




*** 




ex: 


S3 






06 


0> 




rt « 
* a 


.2 " 


« 


3-gS 


One Pint Contains — 


c ~ "h 

oq, . 




p. . 


n 


XI En 

■s r ~> 


VO ^ 

in ■ 




Eure 
L. Alk 

Excel 
L. Alle 












































































oi ! p* 


m 






Ph 


Ph 


Ph 


Ph 




Ph 


Ph 


Ph 


Ph j Ph 


Ph 


Solids. 


grs. 


grs. 


grs. 


grs. 


grs. 


grs. 


grs. 


grs. 


: 

grs. grs. grs. grs. 


grs. 


grs. 


Sodium carbonate . . 


3.024 


o-934 


0.372 


0.782 


I-336 


0.405 


2.552 


6.175 


1.097 I - I °7 0.625 x -875 


4.281 1. 212 


Magnesium carbonate 


4.069 


9.019 


13.072 


3.182 


3.461 


5-399 


2.988 


10.322 


4.586 2.618 


3.667 4.042 


4.883! 5.568 


Iron carbonate . . . 


0.135 


0.031 


O.IOI 


0.079 


0.698 


0.065 


155 


0.089 


no .* . . 


0.375! 0.402 


0.578 0.185 


Calcium carbonate . 


11.443 


12.449 


14-815 


9.520 


8500 


8.084 


7.804 


14-793 


10.795 7.324 


5.165 9.625 12.249 8 845 


Lithium carbonate . 


0.154 


o.374 




0.163 




0.380 


0.071 


o.549 


0.124 0.016 






0-339 


Strontium carbonate . 
Barium carbonate . . 


trace 1 trace 
0.050 o.oq^ 


trace 
0.178 


trace 
0.008 






0.041 
0.206 










trace 


0.094 


trace 


O.OIO . . . 








Potassium chloride . 


1. 122 


1.006 


1.199 


0.536 . . . 


1.078 


0.167 


3.079 


1. 21-2 O.686 . . . 






1.04 1 


Sodium chloride . . 


48.766 


50.055 


63746 


63.328 33.375 


17-734 


16.786 


70.260 


49-795! 8.699 


20.852 


46.330 


37-332 


42.058 


Potassium sulphate . 








0.346 






0.069 












0.269 














. '. 1 : : : 




0.165 




Magnesium sulphate 


















:::::: 


0.268 






trace 


0.002 


O.OI 


0.003 




0.002 


trace 


trace 


trace trace 




































Sodium iodide . . . 


0.011 


0.017 


0.025 


O.OOI 


0.320 


0.006 


0.004 


0.031 


0.015 ... 0.583 


0.529 


0.449 


0.008 


Sodium bromide . . 


0.091 


1.069 


0.192 


0.033 




0.106 


0.079 


0.276 


0.071 ... 0.196 




0.051 


Calcium fluoride . . 
Sodium biborate . . 
Alumina 


trace 
trace 
o.i53 


trace 
trace 
trace 


trace 
0.016 


trace 
trace 
0.052 




trace 
trace 
0.012 


trace 
trace 
0.047 


trace 
trace 

trace 
















trace !o.2i9 0.029 . . . 




0.038 




















... 1 ...... 1 0.875 




Sodium silicate . . . 


















......... 0.500 






Silica 


0.283 


0.105 


0.157 


0.182 


0.256 


0.398 


0.320 


0.013 


0.160 0.339 0067 ... 2 o. 125 


0.401 


Organic matter . . . 
Total 


trace 


trace 


trace 


trace 




trace 


trace 


trace 




trace 


| . . . 


69.502 


75-267 


93-874 


78.215 


47.946 


33-764 


31.042 


105.834 


68.650 21.008 31.827 64.343 59.897 60.089 


Gas. 


cub. in 


cub. in 


cub. in 


cub. in 


cub. in 


cub in 


cub. in 


cub. in 


cub. in cub. in cub. in cub. in cub. in cub. in 


Carbonic acid .... 


5i 

(1866) 


49 
(1871) 


47 


43 


34 


3° 


,0 


57 
(1870) 


50 • • . 29 31 1 40 j 39 
(1870) 


*A 


lumina and ferric oxide. 


2SiI 


ica and alumina. 



Caledonia Springs {Prescott County, Ontario, Canada). — One pint 
of the Saline spring, analyst, T. S. Hunt, contains : sodium carbonate, 
gr. 1.284; magnesium carbonate, 3.769; iron carbonate, trace; calcium 
carbonate, .856; manganesium carbonate, trace; potassium chloride, 
.219; sodium chloride, 46.934; potassium sulphate, .035; sodium 
iodide, .010; sodium bromide, .123 ; alumina, trace; silica, .309; total 
solids, 53-539; carbonic acid gas, 4 cubic inches; flow per minute, 10 
gallons; temperature, 45 ° Fahr. This water is alkaline in reaction; 
valuable in gout, chronic rheumatism, obesity and scrofula. 



CATHARTICS— SALINE MINERAL WATERS. 351 

SALINE MINERAL WATERS— EUROPEAN. 

Homburg {Germany, near Frankfort). — Elizabeth Brunnen ; analyst, 
Liebig; temperature, 50 Fahr. One pint contains magnesium car- 
bonate, gr. 2.01; iron carbonate, 0.46; calcium carbonate, 10.99; 
sodium chloride, 79.15 ; magnesium chloride, 7.79 ; calcium chloride, 
7.77;. sodium sulphate, 0.38; silica, 0.32; total solids, 108.87; car_ 
bonic acid gas, 44.46 cubic inches. These waters are strongly saline 
and contain a fair proportion of iron. Homburg, a small village, is 
situated on the slope of a hill at the eastern extremity of the Taunus. 
There are five springs found here. Their waters are beneficial in dys- 
pepsia with anaemia, obesity, habitual constipation, conditions of plethora, 
hepatic engorgement, etc. 

Kissingen {Bavaria). — Ragoczi ; analyst, Liebig ; temperature 5 1° 
Fahr. One pint contains iron carbonate, gr. 0.24 ; calcium carbonate, 
8.14; potassium chloride, 2.20; sodium chloride, 44.71; magnesium 
chloride, 2.33; lithium chloride, 0.15 ; magnesium sulphate, 4.50; 
calcium sulphate, 2.99 ; calcium phosphate, 0.04 ; sodium iodide, trace ; 
sodium bromide, 0.06; sodium nitrate, 0.07 ; silica, 0.09 ; total solids, 
65.52; carbonic acid gas, 41.77 cubic inches; ammonia, 0.007. Kis- 
singen is situated in a salubrious valley on the river Saal. Its waters 
are adapted to catarrhal dyspepsia with constipation and anemia. In 
gout accompanied by plethora, these waters are often extremely 
beneficial. Being cold and very saline they are not adapted to gastric 
maladies with inflammation. 

Wiesbaden (Germany, Duchy of Nassaii). — Analyst, Fresenius ; 
Kochbrunnen ; temperature, 15 5.75 ° Fahr. One pint contains mag- 
nesium carbonate, gr. 0.08 ; iron carbonate, 0.04 ; manganesium car- 
bonate, 0.604; calcium carbonate, 3.21; potassium chloride, 1. 12; 
sodium chloride, 52.50; magnesium chloride, 1.57; calcium chloride, 
3.62 ; ammonium chloride, 0.13 ; lithium chloride, 0.001 ; calcium 
sulphate, 0.69; calcium phosphate, 0.003; sodium bromide, 0.003 ; 
calcium arseniate, o.OOi ; aluminum silicate, O.004 ; silica, 0.46; total 
solids, 63.463; carbonic acid gas, 16.7; nitrogen, o. 10. This resort is 
situated in a valley on the southerly exposure of the Taunus. Its 
climate is temperate. At Wiesbaden there are twenty-nine springs 
that furnish a supply of hot water, which is used for bathing in every 
form. In the dose of a pint these waters increase the salivary flow, 
produce a sense of gastric warmth, and cause a moderate alvine 
evacuation. In doses of 3 pints to a quart they purge freely. They 



MATERIA MEDICA AXD THERAPEUTICS. 

increase the amount of urine, and more uric acid and urea is eliminated. 
The pulse is quickened, diaphoresis induced, and the faeces made semi- 
fluid. The Wiesbaden waters are particularly beneficial in gout and 
chronic rheumatism without inflammatory symptoms, and the uric acid 
diathesis. They are also employed in facial neuralgia and paralysis 
with advantage. 

Bourbonne [France), and Seltzer, [Duchy of Nassau, Germany) 
furnish saline waters in common use. The former is mildly laxative; 
the latter cool, refreshing and slightly alkaline : it is employed as a 
table-drink under the name Seltzer-Water. 

Baden-Baden. — These are thermo-saline ; temperature 155° Fahr., 
and contain sodium, chloride gr. xvi to the pint. Used chiefly for 
bathing purposes. 

Pullna (Bohemia), furnishes a strong purgative water, consisting 
principally of sodium, gr. 124, and magnesium sulphate, gr. 93 to the 
pint. 

Friedrickshall (near Coburg, Germany) yields a purgative bitter- 
water. It contains sodium and magnesium sulphates, but in less quan- 
tity than the Pullna water. It is largely bottled for exportation, 
and employed in constipation, diabetes mellitus, urticaria, acute gastritis 
and renal calculi (Sprudel Spring). 

Carlsbad (Bohemia) produces an alkaline-saline water, temperature 
162° Fahr. Its two largest ingredients are sodium carbonate gr. ix ; 
and sulphate gr. xx to the pint. This water is pre-eminently useful in 
hepatic affections as jaundice \ biliary calculi ; also in gout, renal calculi, 
acute gastritis, chronic rheumatism, constipation, the uric acid diathesis, 
acidity, diabetes mellitus (mild form) and obesity. 

Marienbad [Bohemia), similar to Carlsbad, except that they con- 
tain more sodium sulphate, carbonic acid and iron. The temperature 
is ^ ; c Fahr. 

Hunyadi Janos (Buda-Fcsth, Hungary). — Analyst, Bunsen: one pint 
contains chiefly sodium carbonate, gr. 13.20; calcium carbonate, 6.04: 
sodium chloride, 11.54; sodium sulphate, 128.97; magnesium sul- 
phate, 137.98; carbonic acid gas free and semi-combined, 8.06 cubic 
inches. An agreeable and certain purgative, employed in constipation^ 
acidity, urticaria, etc. 

Leamington Warwickshire, England). — Ingredients : calcium and 
sodium chlorides, and sodium sulphate. Prescribed in acidity, dyspep- 
sia and constipation. 



CA THAR TICS— RHUBARB. 



353 



MILD ACRID CATHARTICS. 
RHEUM— RHUBARB. 

Description. — Rhubarb is the root of Rheum officinale, and of 
other species of Rheum [Nat. Ord. Polygonaceae). Several varieties 
of rheum are cultivated in Europe and this country, the leaf-stalks of 
which make excellent tarts. 

Fig. 34. 




RHUBARB-ROOT. 



Preparation and Varieties. — Rhubarb is prepared for the 
market by being cleansed, deprived of its cortical portion, cut into 
pieces, pierced through the centre, strung upon a cord, and dried in 
the sun. Three principal sorts were long known : Chinese, Russian or 
Turkey, and European. Chinese Rhubarb is the common variety, and 
23 



354 



MATERIA MEDICA AND THERAPEUTICS. 



is imported principally from Canton. It occurs in roundish pieces, 
sometimes flattened, of a dirty brownish -yellow color externally (the 
cortical portion apparently scraped off)," internally white, with numer- 
ous red, irregularly-curved and interrupted medullary rays, which are 
radially parallel only near the cambium line," and it is often perforated 
with holes. It has a peculiar odor, is gritty when chewed, and tinges 
the saliva of a yellow color ; its powder is yellowish, with a reddish- 
brown tinge. Rhubarb which is porous, brown internally, or of a 
mucilaginous taste, should be rejected. 

Chemical Constituents. — Rhubarb imparts its virtues to both 
water and alcohol, but they are impaired by long boiling. Its most 
important chemical constituents seem to be chrysophan, chrysophanic 



Fig. 35. 




rhubarb; (transverse section of root.) 

acid (C 15 H 10 O 4 ) (an orange-yellow crystalline substance, which is prob- 
ably the active ingredient of goa powder, and will be considered in 
the article chrysarobin — vide Rubefacients),, four resins, erythroretin, 
emodin, phceoretin, aporetin, and two acids, rheotamiic (C 26 H 26 14 ) and 
rheumic (C 20 H l6 O 9 ), but the precise chemical constituents of rhubarb are 
still uncertain, though they have been subjected to numerous analyses. 
It is supposed the therapeutical properties of the drug depend chiefly 
on the conjoint operation of these principles. 

Effects and Uses. — Its taste is bitter and astringent. In small 
doses, rhubarb is an astringe?it tonic. In larger doses, it is a slow and 
mild cathartic, occasionally causing griping and accelerating the pulse, 
but never inflaming the mucous membrane of the alimentary canal 



CA THAR TICS—B UTTERNUT. 355 

like the hydragogues. It tinges the milk and urine yellow. It in- 
creases the secretion of bile, which, however, is unaltered in compo- 
sition (Rutherford). 

Medicinal Uses. — It is much employed as a purgative in diarrhoea, 
in which it is particularly useful from its secondary astringent effects, 
and in dyspepsia attended with costiveness, where it acts both as a 
stomachic and laxative. It is not adapted to febrile or inflammatory 
cases. In the bowel complaints of children, rhubarb deservedly enjoys 
great popularity. Made into a cataplasm and applied to the abdomen, 
it acts as a purgative on children. 

Administration. — Dose, as a stomachic laxative, gr. v-x ; as a 
purgative, gr. xx— 5j, in pill form. The following are the official prepa- 
rations of which the fluid extract and tincture are in commonest use: 
Extract (alcoholic) (extr actum rhei), dose, gr. x-xxx ; fluid extract (ex- 
traction rheifluiduni), dose, f5ss ; mixture of rhubarb and soda (mistura 
rhei et sodce) contains sodium bicarbonate 35, fluid extract of rhubarb 
15, spirit of peppermint 35, fluid extract of ipecac 3, and glycerin 350 
parts, with water enough to make 1000 parts — an excellent preparation 
where rhubarb is indicated combined with an antacid, especially adapted 
to children — dose, for a child, f 5ss-j, for an adult, f5j-iv, or more ; 
tincture (tinctura rhei) (100 parts contain 10 parts of rhubarb and glyc- 
erin, and 2 parts of cardamom, in diluted alcohol) ; aromatic tincture of 
rhubarb (tinctura rhei aromaticd) contains also cinnamon, cloves, and 
nutmeg, and is used in making the aromatic syrup ; sweet tincture of 
rhubarb (tinctura rhei dulcis) contains also glycyrrhiza, anise, and car- 
damom ; tincture of rhubarb and senna (tinctura rhei et sennce) (Warner's 
gout cordial) ; the dose of all the tinctures is fSss-j ; pills of rhubarb 
(pilulce rhei), each pill contains rhubarb gr. iij and soap gr. j ; compound 
pills of rhubarb (pihdce rhei composites), each pill contains rhubarb gr. ij, 
aloes gr. iss, myrrh gr. j, oil of peppermint gr. tV ; compound powder of 
rhubarb (pidvis rhei compo situs) (containing 25 parts of rhubarb, 65 parts 
of magnesia, and 10 parts of ginger) ; syrup (syrupus rhei) contains 
also cinnamon, potassium carbonate, sugar and water ; aromatic syrup 
(syrupus rhei aromaticus) contains aromatic tincture of rhubarb, 1 5 parts, 
syrup, 85 parts — much used in infantile cases, under the name of spiced 
syrup of rhubarb — dose, for an infant, f 5j. 

JUGLANS— BUTTERNUT. 

Description and Habitat. — The bark of the root of Juglans 
cinerea (Nat. Ord. Juglandaceae), collected in the autumn; an indi- 



356 MATERIA MEDICA AND THERAPEUTICS. 

genous forest tree found throughout New England, the Middle and 
Western States and Canada. 

Properties and Constituents. — It is of a fibrous texture, a white 
color, gradually changing to a dark-brown, a feeble odor, and a bitter, 
somewhat acrid taste. It contains nurin, C 36 H 12 O 10 , some tannic acid, 
fixed and volatile oils, resin, etc. 

Effects and- Uses. — It possesses cathartic properties resembling 
those of rhubarb. 

Administration. — It is not given in substance ; the extract (ex- 
tractum jnglandis), is official ; the dose is gr. v-x as a laxative, and 
gr. x-xxx as a decided cathartic, in pill form. 

aloe— ALOES. 

Description, Habitat and Varieties. — Aloes is the inspissated 
juice of the leaves of Aloe vera {Nat. Ord. Liliaceae), a succulent 
herbaceous plant growing in warm countries. Aloes obtained from 
other varieties of aloe is used, but the Pharmacopoeia only recog- 
nizes Aloe Barbadensis and Aloe Socotrina as the source of official 
aloes. The finest kinds are obtained by exudation ; those prepared 
by expression and by boiling are inferior. I. Barbadoes aloes {Aloe 
Barbadensis) when genuine, is the choicest variety. It is produced in 
the island of Barbadoes, in the West Indies, from A. vera, and occurs 
in hard pieces of a yellowish or reddish-brown color, translucent on 
the edges, with a waxy or conchoidal fracture. Its powder is golden- 
yellow ; its odor peculiar, but not unpleasant, and its taste disagree- 
able. 2. Socotrine aloes (Aloe Socotrina), is derived from the island 
of Socotra, on the northeast coast of Africa. The taste of all the var- 
ities of aloes is intensely bitter and very tenacious ; their odor, dis- 
agreeable, that of A. Socotrina aromatic. 

Chemical Constituents. — Aloes yields its virtues to water and 
alcohol. A neutral crystalline principle, termed aldin (aloimini), of 
varying composition, has been extracted from it, which is the cathartic 
principle, and which has been used as a purgative in doses of gr. xV-ij ; 
that from Socotrine aloes is termed socaloin (C 15 H 16 7 ), of Barbadoes, 
barbaloln (C 17 H 20 O 7 ). The resin of aloes, when exhausted of alo'in, 
possesses no purgative properties. 

Effects and Uses. — The taste of aloes is bitter and disagreeable. 
In small doses it is tonic, and in large doses, purgative. As a cathartic 
it is remarkable for the slowness of its operation and its special action 
on the large intestine and the pelvic viscera generally. Hence it is 



CA THAR TICS— SENNA. 357 

objectionable in cases of disease of the genito-urinary apparatus, preg- 
nancy, etc. ; and, on the other hand, is useful in amenorrhcea. It also 
stimulates the hepatic secretion. 

It is principally employed in cases of dyspepsia, accompanied by 
costiveness, dependent on a torpid condition of the large intestine or 
liver. In chronic constipation, combined with belladonna and nux 
vomica and continued for some time in small doses, it often proves 
advantageous. 1^ Alo'in, gr. T V; extracti nucis vomicae, gr. yi ; ex- 
tracti belladonnas, gr. tV. M. ft. pil. I. Sig. — One pill t. d. after 
meals, to be reduced to two per diem if it cause more than one daily 
evacuation. Active exercise, massage and regular habits add greatly 
to the efficiency of this treatment. As a purgative it holds an inter- 
mediate rank between rhubarb and senna. 

Administration. — Dose, gr. v or x-xx, in pill ; it is usually 
given in combination with other cathartics. Aloes is so often mixed 
with impurities that, for medicinal use, it is best employed under the 
form of aloe purificata {purified aloes), which is prepared by straining 
and evaporating an alcoholic solution of Socotrine aloes. The official 
preparations are : Pills of aloes {Pilulce aloes), consisting of equal parts 
of aloes and soap, one pill containing aloes gr. ij ; pills of aloes and 
mastic {pihdce aloes et mastiches), 4 parts of aloes to 1 part of mastic 
and red rose, each (the Lady Webster pill, much used, each containing 
aloes gr. ij) ; pills of aloes and asafcetida {pilulce aloes et asafoetidce), 
(one pill contains of aloes, asafcetida, and soap, j}^ gr. each), useful in 
flatulent constipation ; pills of aloes and myrrh {pihdce aloes et myrrhce), 
or Rufus's pills, aloes 4 parts, myrrh 2 parts, and aromatic powder 1 
part, made into pills with syrup ; employed in a7nenorrhoea, each pill 
containing aloes gr. ij ; pills of aloes and iron {pilules aloes et ferri), 
equal parts of aloes, dried ferrous sulphate and aromatic powder, made 
into pills with confection of rose : each pill contains aloes gr. j ; very 
useful in amenorrhea ; extract of aloes (extractum aloes) ; dose, gr. j-v ; 
tincture {tinctura aloes) (aloes, 100 parts and liquorice root 200 parts, in 
diluted alcohol 1 000 parts), dose, f5j to f oss ; tincture of aloes and 
myrrh {tinctura aloes et myrrhce) (aloes and myrrh, each 10 per cent, in 
alcohol) ; dose, f 5i-iv. Aloin (aloinum) may be had in granules, gr. A— J. 

SENNA. 

a 

Description, Habitat and Varieties. — Senna consists of leaf- 
lets of several species of Cassia {Nat. Ord. Leguminosae), small shrubs 
which grow in the tropical regions of Asia and Africa. The species 



35S MATERIA MEDICA AND THERAPEUTICS. 

recognized as official are C. acutifolia and C. angustifolia. The com- 
mercial varieties of senna which are found in the United States are 
the Alexandria and the India senna. i. Alexandria se7t?ia, which 
comes from the port of this name in Egypt, is made up chiefly of the 
leaflets of C. acutifolia, which are grayish-green, lanceolate in shape, 
unequally oblique at the base, and rather less than an inch in length 
and two-fifths broad, intermingled with the pods, leafstalks, flowers, 
etc., of this plant. They should not have among them Argel leaves 
which are thicker, one-veined and even at the base. 2\ India senna 
is produced in Arabia and consists of the leaflets, intermixed with 
the leafstalks and pods, and is readily recognized by the long (ij4 
inches), narrow, pike-like shape and yellowish-green hue of the leaflets. 
Preparation, Properties and Chemical Constituents. — Com- 
mercial senna is prepared for use by separating the leaflets from the 
stalks, adulterations, etc.; the pods possess cathartic properties, but 
are less active than the leaves. The odor of senna is faint and sickly; 

Fig. 36. Fig. 37. 





ALEXANDRIA SENNA. INDIA SENNA. 

its taste bitter and nauseous. It imparts its virtues to water and alco- 
hol, its infusion being of a reddish-brown color. The chemical com- 
position of senna has long been an unsettled point. By the latest 
analysis it has been found to contain a glucoside, cathartic acid, 
which is insoluble in water, stronger alcohol and ether, but which 
enters readily into watery solution with alkaline and earthy bases in 
which state it exists in senna; this is actively cathartic. Catharto- 
mannit [sennit), sennacrol and chrysoplian have been also obtained; and 
there is probably another purgative principle which has not been 
isolated. 

Effects and Uses. — The preparations of senna are most disagree- 
able and nauseous to the taste. Senna is a prompt, efficient and safe 
cathartic in constipation, well adapted to febrile and inflammatory cases; 
it operates on the entire tract of the intestinal canal, and produces 
watery, feculent discharges. Prof. Rutherford found that senna was a 
mild hepatic stimulant, and rendered the bile more watery. Its tend- 
ency to gripe may in a great measure be counteracted by combining 



CA THAR TICS—B UCK THORN. 359 

aromatic or neutral salts with it; the addition of bitters promotes its 
cathartic activity. 

Administration. — The dose in powder is 5ss-ij. Confectio senna? 
(made with senna, oil of coriander, sugar, figs and pulp of prunes, 
tamarinds and purging cassia) is an excellent mild cathartic, much 
used for pregnant women; dose, 5ij. Of the fluid extract (extr actum 
semice fliudum), the dose is f5j— iv ; the compound infusion (infusum 
sennce compositum) (black draught) contains senna, manna, magnesium 
sulphate and fennel; dose, f5ss-j or more. Syrup of senna (syrupus 
sennce) contains senna, sugar, alcohol and oil of coriander; dose, f5j. 
Pidvis glycyrrhizcE compositus (compound powder of glycyrrhizd) consists 
of senna, glycyrrhiza, oil of fennel, washed sulphur and sugar. It is an 
excellent purgative; dose, a teaspoonful of the powder in half a glass of 
water at bedtime. 

LEPTANDRA— CULVER'S ROOT. 

Description and Habitat. — The rhizome and root of veronica 
virginica, Culver's Physic [Nat. Ord. Scrophulariaceae), an herbaceous 
perennial plant, three or four feet high, with leaves in whorls, and a 
long spike of white flowers, are ranked as a cholagogue cathartic. 

Properties and Constituents. — It consists of a dark-brown 
rhizome, from two to four lines in thickness, several inches in length 
with numerous long, slender radicals. The odor is feeble and dis- 
agreeable, the taste bitterish and somewhat nauseous and acrid. 
Water and alcohol extract its virtues, which depend on leptandrin, 
a glucoside. It also contains resin, saponin, tannin, mannit, etc. 

Effects and Uses. — It is a feeble stimulant to the liver and intes- 
tinal glands, according to the investigations of Rutherford. Adolphus * 
states that it acts on the small intestines, pancreas, and liver, while 
Dutcherf thinks it stimulates the intestinal glands only, but they offer 
no evidence to prove their statements. 

Administration. — Dose of the powdered root, gr. xx to 5j ; of 
an impure resin misnamed leptandrin (made by precipitating a tincture 
of the root with water), gr. ij— iv, in pill-form ; an extract (extr actum, 
leptandrce), dose, gr. ij— iv, and fluid extract (extraction leptandrce 
fluidum), dose, f5ss-j, have been used. 

FRAN GULA— BUCKTHORN. 

Description and Habitat. — The bark of Rhamnus FrangulaJ 
or Alder Buckthorn (Nat. Ord. Rhamnese) is a mild purgative of some 

* Boston Med. and Surg. Reporter, 1868, p. 23. f Ibid., 1868, p. 275. 

% Med. Times, Dec. 5th, 1887, on " R. Frangula and Purshiana," Rusby. 



380 MATERIA MEDIC A AND THERAPEUTICS. 

value. Frangula is a shrub growing to the height often feet or more, 
found in wet places along the northern coast of Africa, throughout 
Europe, and in Siberia. It has alternate oval leaves, slightly pointed 
at the apex, greenish flowers in axillary clusters and small red berries, 
which finally become black and contain two or three roundish- 
angular seeds. 

Properties and Constituents. — The bark comes in small quills, 
grayish or blackish-brown externally and marked with numerous small, 
whitish, transversely elongated warts; the inner surface is smooth, pale, 
brownish-yellow. It has no smell and a sweet and bitterish taste. It 
contains frangulin (C 20 H 20 O 10 ), emodin i resin, tannin, etc. 

Effects and Uses. — When fresh the bark is an active emetic and 
hydragogue cathartic, possessing irritant qualities, but it loses much of 
its acridity in drying, and it is therefore recommended by the Phar- 
macopoeia to be collected at least a year before it is used. When 
dried it is a mild acrid cathartic, proving also somewhat diuretic. It 
is also an anthelmintic of considerable value against thread-worms. 

Administration. — The fluid extract {e xtr actum frangidce fliriduin) 
may be given in doses of f5ss-j ; a syrup is much used, dose, f5i-ij. 

RHAMNUS PURSHIANA— CASCARA SAGRADA. 

Description and Habitat. — Cascara sagrada * or Chittem bark 
is the bark of Rhamnus purshiana {Nat. Ord. Rhamnacese), a small 
tree found on the Pacific slope, growing to the height often to twenty 
feet, with elliptic denticulate leaves, rather large white flowers in 
umbellate clusters, and three-lobed, three-seeded black drupes. 

Properties and Constituents. — The bark comes in thin quills, 
with a grayish periderm, underneath which it is of a reddish-brown 
color ; the inner surface is smooth and yellowish. It is without smell, 
but has a bitter taste. It contains three resins, viz., a brown, red, and 
yellow, which are probably the purgative principles, and recently a 
ferment, glucose, and traces of ammonia have been isolated.f 

Effects and Uses. — Cascara bark is a good and efficient cathartic 
and is useful in habitual constipation. As a cathartic, Dujardin-Beau- 
metz \ rates it between podophyllum and rhubarb. According to 
Cullimore,§ cascara is well combined with capsicum in obstinate con- 

* Med. Times, Dec. 5th, 1887, on '« R. Frangula and Purshiana," Rusby. 
f Am. Jonrn. of Pharm., Feb., 1888. "An Exam, of Cascara Sagrada," by Meier 
and Webber. 

% " Les Nouvelles Medications," 1888, p. 60. 
\ Lancet, London, March, 1885, p, 502 



CA THAR TICS— JALAP. 361 

stipation, which combination obviates the griping and aids the action 
of the former. 

Administration. — Dose of the fluid extract (extractum rhamni 
purshiancB fluidum), TTLx-xxx in water, beginning with the smallest 
dose three times a day and gradually increasing until a free morning 
evacuation is produced, after which the quantity should be carefully 
decreased, giving just sufficient to bring about the necessary morning 
stool. The following preparations may be had in the shops, all un- 
official : elixir cascara sagrada aromatic, f5i contains gr. xv of bark; 
extract of cascara ; and elixir cascara sagrada (tasteless) f§i, containing 
gr. 1 20. As great difference in action is found in many preparations 
of the drug, it is well to begin with a small dose on procuring a new 

supply. 

HYDRAGOGUE CATHARTICS. 

JALAPA— JALAP. 

Description, Habitat and Properties. — Jalap is the tuberous 
root of Ipomcea Jalapa {Nat. Ord. Convolvulaceae), a climbing plant 
of Mexico, which derives its name from the city of Jalapa, near Vera 
Cruz. The tubers are imported usually entire, but sometimes in slices. 
When entire, they vary in size and shape from a walnut to a large 
pear, are hard and heavy — externally, brown and wrinkled, and inter- 
nally, grayish, with brown concentric rings ; they are often furrowed 
with vertical incisions, made to promote drying. They have a heavy, 
rather nauseous smell, and a sweetish, subacrid, disagreeable taste. 
They yield their virtues partly to water, partly to alcohol, and com- 
pletely to diluted alcohol. In the shops jalap is kept in the state of 
powder, which is of a yellowish-gray color. 

Chemical Constituents. — Its active principle is a resin, which 
consists of two portions, both of which are cathartic ; one is soft and 
soluble in ether, the remainder is the glucoside convolvulin (C 62 H 100 O 3 2), 
insoluble in ether ; it contains also gum and starch, which is apt to be 
attacked by worms, the worm-eaten pieces becoming thus the most 
active. 

Effects and Uses. — Jalap is a powerful hydragogue cathartic 
operating with great promptness, and often causing much pain, its 
cathartic action seeming to be local. Rutherford found that jalap was 
an energetic hepatic stimulant, augmenting the flow of bile, which at 
the same time was made more watery. It also increases the secretion 
of the intestinal glands to a marked degree. It is employed as a hydra- 
gogue in dropsy of cardiac or renal origin, when it is often combined 



362 



MATERIA MEDICA AND THERAPEUTICS. 



with cream of tartar ; as a revulsive in cerebral and other affections, 
and to increase the action of calomel in biliousness. It is also a 
valuable hydragogue in ascites, hydrothorax, chronic pleurisy, chronic 
Bright 's disease, cerebral hyperemia, apoplexy, uramia, and is some- 
times employed as an abortifacient. 

Toxicology. — In over-doses it may produce dangerous hyper- 
catharsis. Orfila* ascertained experimentally that 5ij by the mouth 

FIG. 38. 




JALAP-TUBERS. 

is the fatal amount for a dog. No fatal cases have been reported 
in man. 

Administration. — Dose, gr. xv-xxx, in pill; in combination, 
gr. x. The compound powder of jalap (pulvis jalapce compositus) con- 
tains 35 parts of jalap and 65 parts of cream of tartar; dose gr. x-5j. 
The resin (resina jalapce) is extracted by solution in alcohol, and after- 
ward precipitated from the tincture by water; dose, gr. iv-viij in pill; 
of the extract (extr actum jalapce) the dose is gr. j-v. 



*" Toxicologic Generate," t. 1, p. 683. 



CA THAR TICS— POD OPHYLL UM. 363 

BRYONIA— BRYONY. 

Description and Habitat. — Bryonia is the root of Bryonia alba 
and B. dioica (Nat. Ord. Cucurbitaceae) climbing perennial vines, 
growing in the thickets and hedges of various parts of Europe, with 
rough, five-lobed, toothed, alternate leaves and cymes of three or four 
small greenish flowers, and black or red berries containing six large 
spotted seeds. 

Properties and Constituents. — The root is found in the shops 
in transverse sections about two inches in diameter, with a grayish- 
brown, rough, thin bark, the central portion being whitish, with small 
woody bundles arranged in circles, and projecting radiating lines. It 
is without smell, but has a bitter taste. Bryonin (C 18 H 80 O 19 ?), a bitter 
glucoside, has been isolated, and bryoresin (C 37 H 24 18 ), said to be the 
purgative* principle. 

Physiological Effects. — Bryonia is a powerful hydragogue cath- 
artic, resembling jalap in action, but much more violent. It also acts 
on the kidneys, increasing their secretion. 

Toxicology. — In large doses it has produced fatal gastro-intestinal 
inflammation. Christisonf records a fatal case following the swallow- 
ing of two glasses of an infusion (strength not stated), which was 
characterized by violent tormina and purging. If symptoms of its 
irritant action appear, the drug should be discontinued, and opiates, 
demulcents and stimulants administered. 

Medicinal Uses. — In dropsies it may be used as a drastic cathar- 
tic, with a view of also acting on the kidneys, but it is rarely given. 

Administration. — The tincture (tinctura bryonies) is the only 
official preparation ; dose, f 5ss-j or more ; it may be had in infusion, 
dose, fgi. 

PODOPHYLLUM— MAY APPLE OR MANDRAKE. 

Description, Habitat and Official Portion. — Podophyllum pel- 
tatum, (Nat. Ord. Berberideae), is a very common indigenous herba- 
ceous plant, with a long, creeping, perennial root, and an upright stem 
about a foot high, separating at the top into two petioles, each sup- 
porting a large peltate leaf, divided into five or six lobes. At the 
fork of the petioles it bears a single flower, which appears in May, 
the fruit ripening in September. The rhizome and roots are the parts 
used. 

* Journ. de Pharm. et de Clinic, xxvii, 300. Masson. 
f " A Treatise on Poisons," 4th edition, p. 594. 



364 



MATERIA MEDIC A AND THERAPEUTICS. 



Properties. — The rhizome is found in the shops in wrinkled, 
jointed, cylindrical pieces, about two lines in diameter, of a brown 
color externally, and yellowish within, having a tuft of about ten 
nearly simple fragile rootlets on its under surface. The powder is 
yellowish-gray, and has a sweetish smell ; its taste is bitter and acrid. 

Chemical Constituents. — Diluted alcohol is the best solvent of 
podophyllum, which has been found to contain a resin, and from 

Fig. 39. 




PODOPHYLLUM PELTATUM. 



which is derived a resinous body composed of two substances, viz.: 
picropodophyllic acid, inert, and a neutral active principle termed picro- 
podophyllin. Power* has shown that the rhizome contains neither 
berberine nor other alkaloid, and his investigations have been con- 
firmed by Maisch. 

* Proceedings Am. Pharm. Assoc., 1877, p. 420. "On the Resin of Podophyllum 
Peltatum." 



CA THAR TICS— CHELID ONIUM. 365 

Effects and Uses. — The taste of podophyllum is bitter and 
nauseous. Podophyllum is an active hydragogue cathartic, with an 
especial determination to the upper portion of the alimentary canal } 
and a pretty decided cholagogue action which, according to Ruther- 
ford, is due to stimulation of the hepatic secreting apparatus, and is 
greater when purgation is not profuse, and vice versa. He also con- 
cludes that the purgation is due to intestinal irritation, which is essen- 
tially the conclusion reached by Anstie.* Podwissotzki found that 
the effects of podophyllum depended upon picropodophyllin, small 
doses of which caused purging, while large produced vomiting. As 
a cholagogue and to relieve constipation, one of the following pills 
may be given at bedtime : ^ Resinae podophylli, gr. ij ; extracti colo- 
cynthidis compositi, gr. xxiv ; extracti belladonnae, gr. iij. M. Ft. pil. 
xij. The hydragogue effects of podophyllum make it useful in ascites 
and dropsy. It is an ingredient in several cathartic nostrums. 

Toxicology. — Dr. Dudley f reports the fatal poisoning of a 
woman who swallowed gr. v of resina podophylli in mistake for man- 
drake. She was seized with biliary purging and vomiting, which was 
followed by a comatose condition, weak pulse, sighing respiration, 
ending in death in 2^4 days. 

Administration. — Dose, in powder, gr. xx ; of the fluid extract 
(extr actum podophylli fluidum) Tftx-xx ; of the extract {extr actum podo- 
phylli) (alcoholic), gr. v-xv, of the resin (resina podophylli), in pills or 
capsules, gr. %-). The resin is termed podophyllin by the eclectics. 

CHELIDONIUM— CELANDINE. 

Description and Habitat. — Chelidonium majus, known also 
as Tetterwort {Nat. Ord. Papaveracese), is a perennial herb growing in 
waste places, indigenous to Europe, but naturalized in North America. 
The stem is about two feet high, and hairy ; the leaves are alternate, 
the upper ones sessile, light-green above and glaucous beneath, lyrately 
pinnatifid, the pinnae ovate-oblong, obtuse, coarsely crenate or incised. 
The flowers appear from May to September, are of a bright golden- 
yellow color, and arranged in small axillary umbels on long peduncles. 

Chemical Constituents. — Chelidonium contains two alkaloids, 
chelerythrine (C 19 H 17 N0 4 , not identical J with sanguinarine) and cheli- 

* Med. Times and Gazette, Vol. J, pp. 326, 487; "Report on the Phys. Action of 
Podophyllin." 

t N. Y. Med. Record, April 12, 1890, p. 409. 

% Pharm. Zeitung, Berlin, 1886, p. 577 ; also Journ. de Med. de Chir. et de Pharm., 
Bruxelles, 1868, p. 268. 



366 MATERIA MEDICA AND THERAPEUTICS. 

donine (C 19 H 17 N 3 3 ), combined with chelidoninic acid, which is identi- 
cal * with succinic acid. 

Effects and Uses.— The physiological action of this drug has 
not been investigated. The fresh juice is irritant. It has been used 
as a hydragogue cathartic, Binz and Phillips both believe that it 
exerts a stimulating effect upon the hepatic secretions, and class it 
with podophyllum and iris. 

Administration.— Dose of the powder, gr. x-5j ; or it may be 
given in extract or infusion. There are no official preparations. 

IRIS-BLUE FLAG. 

Description and Habitat. — The rhizome and roots of Iris 
versicolor, (Nat. Ord. Irideae), are used as a powerful hepatic stimu- 

FIG. 40. 




IRIS VERSICOLOR ; RHIZOME AND ROOTS. 

lant. The Blue-flag is found in the swampy meadows of North 
America, having sword-shaped leaves and a stout stem, bearing a few 
blue flowers, appearing late in the spring. 

Properties and Constituents. — The rhizome is horizontal and 
jointed; is long and cylindrical in its lower half, broad near its upper 
extremity, and terminated by a circular scar, annulated from the leaf- 
sheaths, of a grayish-brown color, with long rootlets crowded near 
the broad end. It has a slight odor and a nauseous, acrid taste 
(Maisch). It contains a resin, to which probably its medicinal quali- 
ties are due. 

Effects and Uses. — In large doses the fresh plant causes violent 
vomiting and purging, with much depression: in smaller doses it is a 
cholagogue and diuretic. The qualities are impaired by drying. Ruth- 

* Ber. der detitsch chem. Ges., 1 886, XV, p. 704. 



CA THAR TICS— WAHO O. 



367 



erford found that iridin (an impure oleo-resin) was a powerful hepatic 
stimulant, producing less intestinal irritation than podophyllum, but 
greater purgation than euonymin. It was also a decided stimulant 
to the intestinal glands. It is highly recommended in jaundice of 
malarial origin and may be given with advantage in torpidity of the 
liver and dropsy. 

fig. 41. 




IRIS VERSICOLOR. 



Administration. — The fluid extract {extr actum iridis fluidiim) may 
be given in doses of TTLxx-f5j- An extract [extr actum iridis) is also 
official ; dose, gr. j-v. 



EUONYMUS— WAHOO. 



Description and Habitat. — Euonymus, is the bark of Euony- 
mus atropurpureus (Nat. Ord. Celastrineae), a handsome shrub of the 
northern and middle portions of the United States, found in shady 
woods. " Its branches are slightly quadrangular ; the leaves opposite, 
petioled, elliptic-ovate, serrate, and pointed ; the flowers dark-purple, 
in loose cymes of three to six, and appear in June." The fruit matures 
in autumn, and consists of pendulous capsules of a bright crimson 
color. 



368 MATERIA MEDIC A. AND THERAPEUTICS. 

Properties and Constituents. — The bark, as seen in the shops, 
is of a grayish color, mottled with blackish patches on its outer sur- 
face, which is detached in thin and small scales ; inner surface tawny 
and smooth. It is without smell, and has at first a sweetish taste, 
which afterward becomes bitter and acrid. It contains a bitter-princi- 
ple, euonymin (a resinous, hepatic stimulant), resins, euonic acid, etc. 

Effects and Uses. — Euonymus is an excellent cathartic, increas- 
ing the intestinal secretions to some extent, and acting as a powerful 
hepatic stimulant. It may be advantageously used in cases of torpor 
of the liver and constipation. 

Administration. — The extract [extractum euonymi) is the only 
official preparation ; dose, gr. iij-v; of euonymin, gr. J^-iij, both in pills. 

SCAMMONIUM— SCAMMONY. 

Description and Habitat. — Scammony is a resinous exuda- 
tion from the root of Convolvulus Scammonia (Nat. Ord. Convol- 
vulaceae), a twining plant of Syria. 

Preparation, Properties and Constituents. — The finest kind is 
the product of exudation from the sliced root; but most of the drug 
which reaches us is probably obtained by expression, or by evapora- 
tion of a decoction of the root. It comes from the Levant. Genuine 
scammony, termed Virgin Scammony, occurs in light, irregular, friable 
pieces, of various shades of color, from dark-ash to dark-olive, cov- 
ered with a whitish-gray powder, and breaking with a bright-greenish 
fracture ; they should not effervesce with an acid. The scammony of 
the shops, which is always more or less adulterated, is in hard, heavy, 
saucer-shaped cakes, from four to six inches in diameter (sometimes 
broken into pieces), of a dark-ash or slate color. The powder is light- 
gray ; the smell disagreeable, like that of old cheese, the taste at first 
feeble, afterward bitterish and acrid. Scammony is a gum-resin, the 
resin constituting from 80 to 90 per cent, of the weight of good scam- 
mony, and called scammonin (C 34 H 56 16 ). It is a colorless and taste- 
less substance, having a peculiar faint, sweetish smell, and readily solu- 
ble in alcohol and ether. 

Effects and Uses. — Scammony is an energetic hydragogne cath- 
artic, operating sometimes with great violence, and seldom given 
except in connection with other cathartics. When active catharsis is 
indicated it may be employed in ascites, urcemic coma, chro?iic Bright J s 
disease, cerebral hyperemia, apoplexy, and guardedly as an abortifacient. 

Toxicology. — There are no recorded fatal cases of poisoning by 



CA THAR TICS— COL O C YNTH. 369 

scammony. Orfila * ascertained that so much as 5iv in dogs only- 
produced diarrhoea. 

Administration — Dose. gr. v-xv of the pure drug, gr. x-xxx 
of the drug of the shops ; of the resin [resina scammonii), gr. iv-viij, 
in pill. Scammony-resin is of pleasanter smell and taste than jalap- 
resin, produces less griping, and is less apt to cause vomiting. It is 
much used in the form of compound extract of colocynth. 

COLOCYNTHIS— COLOCYNTH. 

Description and Habitat. — Colocynth is the fruit (deprived of 
its rind) of Citrullus Colocynthis or Bitter Cucumber (Nat. Ord. 
Cucurbitaceae), an annual plant of the south of Europe and parts of 
Asia and Africa, resembling the common watermelon. The fruit has 
a thin but hard rind, but is peeled and dried for exportation, and comes 
to us from the Levant. 

Properties and Constituents. — It consists of light, whitish, 
spongy balls, about the size of a small orange, filled with numerous 

FIG. 42. 




COLOCYNTH (PEELED). 

seeds. For medicinal use the pulp only is employed, and the seeds 
which are inactive are rejected. The pulp has a feeble odor and a 
nauseous, intensely bitter taste. It yields its virtues to both water and 
alcohol, and contains a peculiar glucoside termed colocynthin (C 56 H 84 23 ), 
resin, colocynthitin, etc. 

Effects and Uses. — Colocynth is an hepatic stimulant, increasing 
the amount of the biliary constituents as well as rendering the bile 
mqre watery and at the same time stimulating the intestinal glands 
(Rutherford). It is a violent hydragogue cathartic, acting sometimes 
very harshly even in small doses, and in overdoses producing danger- 

* " Toxicologic Generale," Vol. 1, p. 758. 
24 



370 MATERIA MEDICA AND THERAPEUTICS. 

ous, and occasionally fatal, enteric inflammation. Its chief use is to 
unload the bowels in obstinate constipation, and to drain off the fluid 
of dropsies, as hydrothorax, ascites, chronic pleurisy, etc. 

Toxicology. — Christison * describes a case in which a teaspoon- 
ful and a half of the powder killed a man, while Huseman f mentions 
an instance in which 5% proved fatal to a woman, and of recovery- 
after swallowing 5iij. 

Administration. — The dose is gr. v-x. It is seldom, however, 
administered alone. The extract (extraction colocynthidis) (alcoholic) is 
used chiefly in the preparation of the compound extract (extr actum 
colocynthidis composition) , which contains also aloes, resin of scammony, 
cardamom and soap ; this is a favorite prescription, but it is apt to gripe? 
and it is well to combine some aromatic with it, as a little oil of cloves 
or capsicum ; dose, gr. v-x, in capsule. Vegetable cathartic pills (J>ilida 
cathartics vegetabiles) have been added to the U. S. P. of 1890. They 
contain compound extract of colocynth, extract of hyoscyamus, jalap 
and leptandra, resin of podophyllum, oil of peppermint and water ; 
dose, 1 to 3 pills. One pill contains extract of colocynth compound, 
gr. j ; extract of hyoscyamus and jalap, each, gr. ]/ 2 ; extract of lep- 
tandra and resin of podophyllum, each, gr. ]/^ ; and peppermint oil, 
gr. y&. Prescribed in constipation. 

CAMBOGIA-GAMBOGE. 

Description and Habitat. — Gamboge is a gum-resin procured 
from Garcinia Hanburii {Nat. Ord. Guttiferae), a tree of Siam and 
Cochin-China. 

Preparation, Properties and Constituents. — The juice is col- 
lected in a bamboo joint as it exudes from a spiral incision in the bark, 
extending nearly round the tree, and is afterward reduced to a solid 
consistence by the aid of heat. The sap exudes slowly for several 
months, and the tree is not injured by the process. It is imported 
from Canton and Calcutta, and occurs in cylindrical rolls from one to 
three inches in diameter, of an orange color, known as pipe gamboge, 
or in irregular masses (which are less pure), weighing two to three 
pounds or more, called cake or lump gamboge. Good gamboge is 
opaque, brittle, inodorous, its taste acrid, and breaks with a vitreous 
fracture ; its powder is bright-yellow. It is a gum-resin, forming a 

* " A Treatise on Poisons," 4th ed., p. 595. 
I " Handbuch der Toxicologic," p. 625. 



CA THAR TICS—ELA TERIN. 371 

yellow, opaque solution with water and a golden yellow solution with 
alcohol ; it contains from 20 to 25 per cent, of gum and from 75 to 80 
per cent, of a resin termed cambogic acid (C 20 H 23 O 4 ). 

Effects and Uses. — Locally, the powder is sternutatory. Gam- 
boge is a powerful hydragogue, and in overdoses has proved fatal. It 
often causes vomiting through gastro-intestinal irritation, and in large 
amounts has produced death merely from depression. It is employed 
in obstinate constipation ; in dropsies, combined with cream of tartar 
or jalap, and has been used to destroy tcenia solium. 

Toxicology. — Christison * mentions a case in which 5j proved 
fatal, the symptoms being excessive vomiting, purging and faintness. 

Administration. — Dose, gr. ij-vj. It is usually prescribed with 
other and milder cathartics, to promote and accelerate their action. 
Compound cathartic pills [pilules catharticez composites) are made by 
mixing compound extract of colocynth, 80 parts ; extract of jalap, 30 
parts ; calomel, 60 parts ; and gamboge, 15 parts ; with water enough 
to make 1000 pills. Dose 1 to 3 pills. One pill contains extract of 
colocynth compound, gr. i%\ calomel, gr. i ; extract of jalap, gr. y 2 ; 
gamboge, gr. J^ ; prescribed in constipation. 

ELATERINUM— ELATERIN. 

Description and Habitat. — Elaterin (C 20 H 28 O 5 ) is a neutral 
principle extracted from elaterium, a substance deposited by the juice 
of the fruit of Ecballium Elaterium, or Squirting Cucumber [Nat. Ord. 
Cucurbitaceae), an annual vine of the south of Europe, now cultivated 
in England. The fruit has the shape of a small oval cucumber, and, 
when fully ripe, separates from the peduncle, and throws out its juice 
and seeds with considerable force, through an opening in the base. 

Preparation, Properties and Constituents. — Pure elaterium is 
obtained by slicing the fruit and allowing the juice to drain through a 
sieve. The juice deposits a sediment, which dries in very light, thin, 
nearly flat, pulverulent, greenish-gray cakes, and is the genuine 
elaterium. It is almost inodorous, and has a bitter, acrid taste. The 
commercial elaterium, which is obtained from England, is made by 
expression. The drug is to be considered inferior when it is dark- 
colored, much curled, and hard. Elaterium yields its virtues to 
alcohol, and not to water. Elaterin {elaterinum) (C 20 H 28 O 5 ), its active 
principle, crystallizes in beautiful colorless, needle-shaped crystals^ 

* " A Treatise on Poisons," 4th ed., p. 603. 



372 MATERIA MEDICA AND THERAPEUTICS. 

without smell, but of a bitter, sharp taste, insoluble in water, but 
readily soluble in alcohol. 

Effects and Uses. — platerium is an hydragogue cathartic of great 
violence of operation, possessing some diuretic action, and in over- 
doses has frequently proved fatal. It is an efficient remedy in the 
treatment of dropsies, as hydrothorax, ascites, chronic pleurisy, and is 
also a useful revulsive in cerebral affections ; but in administering it 
considerable caution is required. It is occasionally employed as an 
hydragogue in urcemic coma,chronic Bright s disease , cerebral hypercemia, 
and as an abortifacient. 

Toxicology. — Beck* mentions a case in which extract of elate- 
rium, gr. ijf, with gr. xvj of rhubarb, caused death, the chief symp- 
toms being incessant vomiting and purging. 

Administration. — Trituration of elaterin (trituratio elaterini) con- 
sists of elaterin io parts and sugar of milk 90 parts, thoroughly 
triturated; dose, gr. %-]. It is safest to begin with the smaller dose. 
Elaterin (elaterinunt) proves powerfully cathartic in doses of gr. 2V -xV • 

OLEUM TIGLII-CROTON-OIL. 

Description and Habitat. — Croton-oil is a fixed oil obtained 
from the seeds of the Croton Tiglium (Nat. Ord. Euphorbiaceae), a small 
tree of the East Indies. The croton-seeds resemble the castor-seeds in 
shape and size, and consist of a blackish shell, sometimes covered 
with a yellowish-brown epidermis, and inclosing a yellowish oily 
kernel. They are highly irritant and cathartic, but are not imported 
into this country. 

Properties and Constituents. — The croton-oil of the shops is 
obtained by expression, and is a mixture of the fixed oil proper, the 
resin and tiglinic acid. According to Senier f the vesicating principle 
resides in the non-volatile fatty acids, or in that part of the oil soluble 
in alcohol. The oil is made both in India and England, the Indian oil 
being of a pale straw color, and the English reddish-brown ; the latter 
is the variety now found in the shops. It has a viscid consistence^ 
which is increased by age, a faint, peculiar odor and an acrid taste ; it 
is soluble in ether and the volatile and fixed oils, and partially so in 
alcohol. The drastic principle has been found by Senier (loc. cit.) to 
exist in that portion of the oil insoluble in alcohol, which he styles the 



* " Med. Jurisprudence," 6th ed., II, p. 578. 

f The Pharm. Journ. and Trans., 1883, p. 446. 



CA THAR TICS— CR O TON- OIL. 



373 



"Alcohol non-soluble, non-vesicating oil." This he determined 
experimentally to be purgative in the dose of TTL 1V2, his work being 
confirmed by Dr. Meek (same article as Senier's). The seeds contain 
a volatile oil, a fixed oil, retin, acetic, butyric, and valerianic acids, 
together with an acid termed tiglinic (C 5 H 8 2 ). Tests. — There are no 
exact chemical tests by which croton-oil can be recognized in medico- 
legal cases. 

Physiological Effects. — Rubbed on the skin, croton-oil causes 
rubefaction and a pustular or vesicular eruption ; and rubbed over the 
abdomen it will sometimes purge. The eruption ordinarily appears in 
a few hours and lasts about four days. The taste of croton-oil is acrid 
and pungent, and is irritant to the throat and causes a sense of heat in 
the stomach. Taken internally, it is a powerful hydragogue purgative, 

fig. 43. 




CROTON-OIL SEEDS. 



occasionally increasing the secretion from the kidneys. Drops, j-ij 
are usually sufficient to produce active catharsis, but sometimes as much 
as gtt. viij-x may be taken without affecting the bowels. It operates 
very speedily, often causing evacuations in half an hour, and is apt to 
produce considerable sedation of the vascular system. 

Toxicology and Antidotes. — In overdoses it has frequently 
proved fatal, destroying life rather by its depressing influence on the 
functions of organic life through the nervous system than by a local 
irritant action. When the latter is present it partakes of the character 
of gastro-enteritis. The fatal quantity varies widely, since ITLiij killed 
a child aged 13 months,* while recovery has followed after swallowing 
f5j (a child f), and in adults f5ij,J f5ij t (without purging) and f §j. § 
In cases of poisoning demulcents, as linseed-tea, must be given, and 
the stomach emptied. 

* Med. Times and Gazette, I, 1870. 

f " Handbuch der Toxicologic," Huseman, p. 443. 

\ Am. J. Med. Set., April, 1 874, 416. 

$ Boston Med. and Surg. Journ., 1868, p. 294. 



374 MATERIA MEDICA AND THERAPEUTICS. 

Medicinal Uses. — Croton-oil, from the smallness of the dose 
required and the speediness of its action, is an extremely valuable 
purgative in obstinate constipation, as an hydragogue in ascites, and in 
cerebral disorders, particularly hyperemia and apoplexy. Its exhibi- 
tion in the latter disease is indicated when the arterial tension is high 
and there is evidence of cephalic congestion, as manifested by an in- 
compressible pulse and facial flushing. Cardiac failure is a contrain- 
dication to the use of croton-oil in apoplexy. As a counter-irritant, it 
is often employed with advantage in pulmonary and laryngeal affec- 
tions, affections of the joints, etc. In chronic laryngitis, and bronchitis, it 
may be applied externally diluted with olive-oil upon a camel's hair 
brush about the skin of the throat or over the sternum. Fox* recom- 
mends the application of croton-oil to obstinate patches of ringworm. 

Administration. — Dose, gtt j-ij, made into pill with bread-crumb. 
For external use, it may be diluted with one or two parts of olive- oil 
or oil of turpentine. 

MERCURIAL CATHARTICS. 

The preparations of mercury employed as cathartics are calomel 
and blue pill. Their purgative effects depend partly on the increased 
flow of bile which they occasion, and partly on the stimulus which they 
give to secretion from the mucous follicles of the intestinal canal and 
from the pancreas. They probably do not increase the amount of bile 
secreted, but by irritation of the orifice of the duct, cause reflex con- 
traction of the ducts and the gall-bladder, and consequently expulsion 
of that already secreted. They are rarely employed alone, owing to 
the slowness and uncertainty of their action, but are usually combined 
with or followed by other cathartics (as jalap, senna, rhubarb, com- 
pound extract of colocynth, or some of the saline preparations). The 
mercurial cathartics are usually administered with a view of combining 
a purgative action with an effect on the secretions, particularly that of 
the liver ; also as anthelmintics and as revulsives in cerebral and other 
affections. They are well adapted to infantile cases, from the facility 
of their administration, and are especially beneficial in the ephemeral 
febrile attacks to which children are subject ; they, moreover, rarely 
produce salivation in children. 

Hydrargyri Chloridum Mite {Mild Mercurous Chloride, or Calomel). 
(Noticed at length under the head of Alteratives^ Dose, as a cathartic, 

* Brit. J. Dermatol, Sept. 1893. 



CATHARTICS— ENEMATA. , 375 

gr.j-xij, in pill, powder, granules or triturates, to be followed, in from 
four to six hours, by some other cathartic. Sometimes, when it is 
exhibited with a view to a full action on the liver, gr. J^-ij may be taken 
every hour or two until the whole purgative dose is taken ; or it may 
be administered at bedtime, with an aperient draught the next morn- 
ing, as a Seidlitz powder. For children, larger doses are required in 
proportion than for adults : gr. %-v] may be given to a child from 
three to six years old. Calomel occasionally causes griping pains in 
the bowels, with bilious vomiting ; this is attributable, not to any irri- 
tant qualities in the medicine, but to the acrid character of the bile 
secreted. Calomel is an ingredient of the compound cathartic pills. 

Massa Hydrargyri (Mass of Mercury) , commonly called blue pill ox 
blue mass (see Alteratives}, is analogous in its cathartic action to calo- 
mel, but milder and less certain. It is given in about the same doses 
and in the same combinations, etc., in pills or capsules. 

enemata— (From Ivlrjfii, I inject). 
In cases of (a) irritability of the stomach — or with the view of (b) 
hastening the action of cathartics taken by the mouth — or (c) to remove 
feculent accumulations in the lower bowels — or (d) to relieve tympan- 
ites—or (e) for the purpose of revulsion, or (f) the removal of thread- 
worms — or (g) as astringents in intestinal fluxes, (h) as emollients to 
soothe the lower bowel, or(i) as restoratives, and finally as (j) sedatives, 
enemata are frequently administered. They may be conveniently classi- 
fied into (i) purgative, (2) forced, (3) anthelmintic, (4) astringent, (5) 
emollient, (6) nutrient, and (7) anodyne. 

1. Purgative Enemata. — When it is desired simply to open the 
bowels mechanically, as in obstinate constipation, peritonitis, typhilitis, 
etc., tepid water, flaxseed tea, or other demulcent infusion may be em- 
ployed. The common laxative enema co'nsists of a tablespoonful of 
common salt, molasses and lard- or olive-oil, each in two-thirds of a 
pint of warm water; castor-oil or Epsom salt may be added to increase 
the cathartic effect. Senna-tea or some other cathartic infusion is 
often employed. Glycerin, f5ss-j, with an equal quantity of water, 
injected into the rectum, will produce in a few minutes, an evacuation, 
usually normal in consistence. To relieve flatulency, oil of turpentine 
(foss-j, in emulsion), or milk of asafcetida (fSij-iv) may be given. The 
latter is a suitable preparation in infantile cases. 

2. Forced Enemata. — In some cases, as intussusception of the in- 
testines, or even in hernia, much good may be accomplished by the 



376 MATERIA MEDICA AND THERAPEUTICS. 

gradual distention of the bowel by means of forced enemata of warm 
water. This is accomplished by means of a long flexible rubber-tube, 
one end of which is armed with a rectal tube having a blunt conical 
point and several large openings to admit of the free passage of the 
water. The other end of the flexible tube is attached to a large funnel, 
and the tube has a stop-cock upon it. By elevating the funnel and 
filling it with water, a continual stream can be thrown into the bowel, 
the force being regulated by the height at which the funnel is held 
and by the stop-cock. In this way from five to ten pints of water can 
be thrown into the bowel, filling the large intestine and even passing 
the ileo-caecal valve. The injection should be conducted slowly and 
carefully. Several cases of intussusception have been reported where 
the symptoms subsided under this treatment, the invaginated portion 
of the intestine having slipped back to its proper place during the dis- 
tention. This method should not be resorted to when there is reason 
to think that sphacelus of the bowel is taking place, as it might result 
in a rupture. 

3. Anthelmintic Enemata. — For the removal of thread-worms, 
infusion of quassia makes an excellent enema. For the same purpose 
injections of salt and water, oleum terebinthinae, f5iv-vj with the yolk 
of an Ggg in a pint of tepid water, or lime-water alone, are serviceable 
remedies. 

4. Astringent Enemata. — These are employed to arrest the 
haemorrhage of hemorrhoids ', to cure chronic dysentery and diarrhoea, 
to restrain muco-intestinal discharges, as in proctitis, and to heal rectal 
ulcers. Ice-cold water injections are employed against rectal and in- 
testinal hcemorrhage. Nitrate of silver (p. 203), gr. ij-v to water, Oj, at 
100° F., zinc sulphate, or alum gr. iv-viii to warm water Oj are suit- 
able therapeutical measures for the relief of cases of dysentery and 
diarrhoea after the subsidence of the acute symptoms. The silver- 
enema is also applicable to the healing of ulcers. The patient should 
be in the dorsal position, the hips elevated, and the fluid permitted to 
flow in through a tube attached to a syphon bag. By this means the 
entire colon can be irrigated. The silver-injection may cause pain. 
¥ or piles the decoctions of white oak-bark, geranium and hamamelis 
are applicable ; in chronic proctitis, silver nitrate, gr. v-xx, water, f §i ; 
or tannin, gr. v-x to water f Sj ; both to be introduced through a long 
tube. 

5. Emollient Enemata. — These are employed to relieve inflam- 
mation and irritability of the rectum and lower bowel. For this pur- 



DIAPHORETICS. 377 

pose decoctum lini, mucilago ulmi, decoctum cetrariae and decoctum 
chondri are used. They are besides nutritious, particularly the two 
last. 

6. Nutrient Enemata. — In cases of exhaustion and haemorrhage, 
as in cancer of the stomach, dilatation of the stomach, gastric ulcer, 
chronic gastritis, the following substances may be injected daily as 
restoratives, viz. : beef-tea, Siv-viij with HC1 Tftx and glycerole of pep- 
sin, §ij ; defibrinated blood (see p. 79) ; milk and gruel ; beef-tea and 
brandy. Pancreatin may be advantageously added to the above, and 
if the injection be intolerant, a little laudanum. 

7. Anodyne Enemata. — These are administered in painful and 
ca?zcerous affections of the rectum, bladder, vagina and urethra, as fol- 
lows : laudanum, f 5 J^-j ; tinctura belladonnae, ,gtt. xv-xxx; cocaine, 
gr. }{-], to water, fgij-iv. 

ORDER III.— DIAPHORETICS. 

Diaphoretics (from dcacpopew, I transpire); called also sudorifics, 
are medicines which promote transpiration from the skin. The action 
of the cutaneous exhalants may be increased by various means. The 
mere introduction of a large quantity of fluid into the system will pro- 
duce sweating, if the system be kept warm. Exercise, and a warm 
temperature, by determining a flow of blood to the cutaneous vessels, 
act in the same way. Nauseants occasion diaphoresis by relaxing 
the orifices of the cutaneous vessels ; stimulants, by exciting them to 
increased secretion. Diaphoretics are employed therapeutically for 
their evacuanl, revulsive and alterative effects, and to promote absorption. 
Different classes of diaphoretics are required for different morbid con- 
ditions. Remedies which diminish the amount of perspiration are 
termed anhidrotics (from dv, priv., and Idpd)^, sweat). Atropine and 
dilute sulphuric acid are anhidrotics ; the former acting by depressing 
the perspiratory nerves in the glands. 

1. Nauseating Diaphoretics. — Most of the emetics in nauseating 
doses, produce a powerfully relaxing diaphoretic action, and are much 
employed, with this view, in inflammatory cases, when not contraindi- 
cated by the presence of gastric irritability. The Preparations of 
Antimony (p. 249) and Ipecac (p. 324) are chiefly resorted to as nau- 
seating diaphoretics. Ipecac is often given as a diaphoretic, in com- 
bination with opium, in the form of Dover's Powder {see p. 92). 

2. Refrigerant Diaphoretics. — The saline and ethereal pre- 
parations classed as refrigerants (p. 255) produce a gentle relaxing 



378 MATERIA MEDICA AND. THERAPEUTICS. 

diaphoretic action, unattended with nausea. They are used to allay 
febrile excitement and reduce the temperature of the body. 

3. Stimulating Diaphoretics. — This group includes the diffus- 
ible stimulants, the aromatic substances generally of every class, and 
many narcotics, particularly opium and camphor. They are contra- 
indicated in high inflammation, but are very serviceable in rheumatic 
and pulmonary affections, after vascular excitement has been reduced, 
and in all diseases where the surface of the body is cold. Opiurn, in 
the form of Dover's Powder, may be employed in inflammatory cases, 
where other stimulating diaphoretics are inadmissible, and is given 
with advantage in an early stage of acute rheumatism, dysentery and 
catarrh of the air passages, unless the action of the pulse be very 
strong, when this should be previously moderated. The operation of 
the diaphoretic stimulants is promoted by the free use of warm diluent 
drinks, and warm covering to the body. 

PILOCARPUS-JABORANDI. 

Description, Habitat and Properties. — Pilocarpus is the leaf- 
lets of Pilocarpus selloanus and of P. Jaborandi (Nat. Ord. Rutaceae), 
a shrub of some of the northern provinces of Brazil, growing to the 
height of about five feet, with a long cylindrical root, about three- 
quarters of an inch in thickness, and imparipinnate leaves (with ana- 
stomosing veins near the margin) about nine inches long, with from 
three to five pairs of opposite, oblong-lanceolated, grayish-green leaf- 
lets, with an odd terminal one, which are dotted with a number of 
pellucid glands. There are several plants known in South America 
under the name of Jaborandi, and the variety brought here is from 
Pernambuco. The leaflets have a characteristic odor (resembling a 
mixture of Indian hemp, matico and cubebs) and a warm, aromatic 
taste. 

Chemical Constituents. — They yield pilocarpine (C n H 16 N 2 2 ), 
an alkaloid of a bitter, nauseous, astringent taste, slightly soluble in 
water, freely in alcohol, ether and chloroform, and an amorphous alka- 
loid termed jaborin* — probably a derivative of pilocarpine — has been 
isolated, which resembles atropine in action ; they contain also a 
volatile oil (chiefly pilocarpine, C 10 H 16 ). Recently MM. Hardy and 
Calmels f have obtained pilocarpine synthetically from a derivation 



* Arch, fur exper. Pathol, u. Pharmacol., XII, p. 366; Hamack an* Meyer, 
f Compt. Rend, en, quoted in Dublin M. /., Dec. 1887. 



DIAPHORETICS— PILOCARPUS. 



379 



of pyridin, which is stated to be identical in action with the natural 
base. 

Incompatibles. — Tannic acid, the caustic alkalies, the ferric and 
metallic salts. 

Aids. — As a diaphoretic, sarsaparilla and mezereum ; upon the 
heart by aconite, veratrum viride, etc. 

Contraindications. — Pilocarpus should not be given in affections 
of the gastro-intestinal mucous membrane, nor in weak heart due to 
disease of the cardiac muscle or ganglia, or of the valves. 

fig. 44. 




PILOCARPUS PENNATIFOLIUS. A, LEAF ; B, C, FLOWERS. 

Physiological Effects. — The action of pilocarpus and of its 
alkaloid (upon which its effects depend) has been studied by Ringer, * 
Murrell, Langley,f Harnack and Myer {loc. cit.) and many others, 
with the following results : Galezowski J found that an aqueous solu- 
tion of pilocarpine nitrate applied to the conjunctiva contracted the 
pupil. The taste of jaborandi is warm and pungent ; in full doses it is 
likely to produce nausea. It paralyzes the vaso-motor nervous system, 
and rapidly excites the circulation ; but the pulse is soon slowed and 
the arterial tension is greatly diminished. According to Ringer {loc. 
cit?), it paralyzes the ventricles separated from the auricles by a direct 
action. It is a powerful diaphoretic, augmenting both the watery and 
solid ingredients of the sweat enormously, probably by a direct action 

* Practitioner, 26, 1881, p. 5. f Journ. of Physiology, 1878, p. 339. 

\ Comptes Rendus de la Societe de Biologie, 4, 1877, p. 401. 



380 MATERIA MEDICA AND THERAPEUTICS. 

on the peripheral endings of the nerves. The amount of urea elimi- 
nated by the skin is especially heightened. The sweat is said to be 
acid at first, becoming neutral and, finally, alkaline. The temperature, 
as a rule, rises at first, but coincident with the profuse sweating, is 
lowered. It causes salivation, which is sometimes very profuse, in 
which case the diaphoretic effect is less marked, and vice versa. The 
sialagogue effect probably depends on a direct action of the drug upon 
the glands. The gastric and bronchial secretions are also increased. 
These effects continue for from three to six hours. Disturbance of 
the vision, contracted pupils, cerebral uneasiness, and after a time, 
vomiting, generally accompany these eccritic results, which effects are 
often followed by drowsiness. In much of its action, especially on 
the secretions, an antagonism exists between pilocarpus and bella- 
donna (Langley, loc. cit). Pilocarpus appears to stimulate the nutri- 
tion of the hair, and in one case, Prentiss,* under its use, noticed a 
change in the color of the hair from blonde to black. It is eliminated 
by the secretions on which it acts. 

Medicinal Uses. — In cases of pleuritic effusion, especially after the 
subsidence of the inflammatory symptoms, pilocarpus or its alkaloid 
often quickly removes the transudation. In the renal dropsy and 
urcemia of chronic Brighfs disease it is frequently invaluable on ac- 
count of its diaphoretic effects and because it increases the elimination 
of urea by the skin. It has also been used with success in puerperal 
eclampsia due to kidney disease, in humid asthma and bronchorrhcea, in 
some cases of mumps, in chronic enlargement of the cervical glands, in 
adenitis of the inguinal glands, and as a galactagogue. Pilocarpine 
has been found useful in arresting severe and prolonged hiccough, in 
doses of gr. y^ hypodermically employed. It is recommended in 
diabetes insipidus and in squamous affections of the skin, as phthiriasis 
and psoriasis, and has been used locally and hypodermically with ad- 
vantage in alopecia. By reason of its diaphoretic action it is one of 
the remedies used in anidrosis. 

Administration. — Dose of the fluid extract (extr actum pilocarpi 
fluidum), f5ss-j ; of pilocarpine hydrochlorate (pilocarpine? hydrochloras), 
gr. yi~yi\ hypodermically, gr. to-% ; it can be had in tablets. 

ALTERATIVE DIAPHORETICS. 
Under this head are comprised a class of diaphoretic medicines 
which produce a gradual and nearly insensible increase of the cuta- 

* Phila. Med. Times, July 2d, 1881. 



DIAPHORETICS— SARSAPARILLA. 381 

neous secretion, and are supposed to promote the elimination of nox- 
ious matters from the blood through the vessels of the skin. They 
are employed chiefly in chronic rheumatic and cutaneous affections, and 
in secondary syphilis. 

SARSAPARILLA. 

Description and Habitat. — The name of Sarsaparilla is applied 
to the root of Smilax officinalis, S. medica, S. papyracea and other 
species of Smilax (Nat. Ord. Liliaceae), twining prickly shrubs of 
Mexico, Guatemala and the warm countries of South America. 

Properties and Varieties. — The roots consist of numerous 
wrinkled, slender pieces, of the average thickness of a writing-quill, 
several feet long, springing from a common head or rhizome, and are 
frequently found in the shops with portions of the stem attached. 
Several varieties are known, but Honduras sarsaparilla is«the most 
common variety in the United States, consisting of several long, thin 
roots, folded lengthwise, of a dirty grayish or reddish-brown color. 

Sarsaparilla roots are several feet in length, about the thickness 
of a goose-quill, cylindrical, more or less wrinkled longitudinally, and 
consist of a whitish-brown or pink cortical portion covered with a 
thin, gray, brown or red epidermis, and inclosing a layer of whitish 
ligneous fibre and a central pith. The cortical portion is more active 
than the interior portion; the central medulla contains a good deal of 
starch. Sarsaparilla, in the dried state, is nearly inodorous, but its 
decoction has a strong smell. 

Chemical Constituents. — Water and diluted alcohol extract its 
virtues. It contains three homologous* glucosides, called saponin, 
parallin and sarsasaponin, a volatile oil, etc. The Vera Cruz and 
Jamaica varieties contain the most saponin, and are therefore the best 
for medical purposes. 

Aids. — Guaiac, mezereum and pilocarpus. 

Effects and Uses. — Sarsaparilla has a mucilaginous, slightly 
bitter faste, and when chewed for some time produces a persistent acrid 
impression on the mouth ; this acridity of taste is the criterion of good 
sarsaparilla. The physiological effects of sarsaparilla, which depend 
on its glucosides, beyond an increase in the flow of the secretions, are 
not very obvious ; in large doses it produces nausea, vomiting, 
diarrhoea and salivation. Its efficacy in eradicating various morbid 



* Disse7-t. Inang. Dorpat, 1892, Schultz, quoted; also Deutsche Med. Wochen, 30 
Juni, 1892, R. Kobert. 



382 MATERIA MEDICA AND THERAPEUTICS. 

symptoms is believed in by some, though denied by others; and its 
mode of action, which resembles the mercurials in certain points, is 
popularly attributed to a purifying influence on the blood through the 
function of the skin. It is employed in secondary and tertiary syphilis, 
particularly where the disease resists or is aggravated by the use of 
mercury; also in chronic rheumatism, skin-diseases, as eczema pustu,- 
losum, and cachectic conditions of the system generally. 

Administration. — Dose, of the powder, 5ss three or four times 
a day — never used, however, in this form. The compound decoction 
(decoctum sarsaparillce compositum) is made by boiling sarsaparilla io 
parts, sassafras, guaiacum wood and liquorice root of each 2 parts, and 
mezereum I part, in ioo parts of water, then macerating, and, after 
straining, adding water enough to make the decoction measure IOO 
parts : doSe, fSiv-vj, t. d. The compound syrup (syrupus sarsaparillce 
compositum), (which contains also senna, glycyrrhiza, sassafras, anise 
and gaultheria) is a favorite preparation; corrosive sublimate should 
not be given with it, as it is decomposed, it is said, into calomel ; 
dose, f§ss. Of the fluid extract {extr actum sarsaparillce fluidum) y the 
dose is f5ss. The compotind fluid extract (extractum sarsaparillce flui- 
dum compositum) contains glycyrrhiza, sassafras, mezereum, glycerin 
and alcohol ; dose, f5ss, repeated. 

GUAIACI LIGNUM— GUAIACUM WOOD. 
GUAIACI RESINA— GUAIAC. 

Description, Habitat and Properties. — Guaiacum Wood, or 
Lignum Vitce, and Guaiac are products of Guaiacum officinale and G. 
sanctum (Nat. Ord. Zygophyllese), large evergreen trees of South 
America and the West Indies. The wood, which is remarkable for its 
hardness and density, is imported in logs or billets, covered with a 
thick gray' bark ; the outer portion or sap-wood is of a pale-yellow 
color, the inner of an olive-brown. The heart-wood is the official 
portion ; it is usually kept in the shops in the state of shavings or 
raspings : they are inodorous unless heated, and when chewed for some 
time they have a bitterish pungent taste. Guaiacum wood yields its 
virtues to alcohol, and partially to water; they depend on the guaiac 
contained in the wood. 

Guaiac. — PREPARATION, PROPERTIES AND CHEMICAL CONSTITU- 
ENTS. — Guaiac is a peculiar resin, obtained from Guaiacum officinale 
by spontaneous exudation, by incision, by dry heat, or by decoction of 
the comminuted wood. It comes in large, irregular, semi-transparent, 



DIAPHORE TICS—MEZERE UM. 383 

brittle pieces, of varying size — externally of a deep green or olive 
color, and internally red. It has a slight balsamic odor, which is 
rendered stronger by heat, and an acrid taste. Water dissolves it 
partially ; alcohol completely. It contains guaiaconic and guaiaretic 
acids, guaiac beta-resin, gum, ash, guaiacic acid, coloring matter, etc. 
(Hadelich*). Guaiacol maybe obtained from the resin. Most oxi- 
dizing agents, as nitric and chromic acids, etc., -produce a blue, then 
green, and finally a brown color, with tincture of guaiacum. 

Incompatibles. — Spirit of nitrous ether and the mineral acids ; 
water precipitates the resin in both tinctures. Oxidizing agents pro- 
duce a play of colors with the tincture. 

Aids. — Sarsaparilla, mezereum and pilocarpus. 

Effects and Uses. — Guaiac resin has a hot, pungent taste, 
increasing the flow of saliva, and leaving an acrid sensation in the 
mouth and throat. It produces a sense of warmth in the stomach, 
and in large amounts, vomiting. Guaiacum wood and guaiac are 
stimulant diaphoretics, also increasing the secretion of the bronchial 
mucus, and in large doses, cathartic. They are principally used for 
their alleged alterative virtues in chronic rheumatism, rheumatic 
arthritis, and skin-diseases ; guaiac has been used as a laxative. In 
acute tonsillitis the tincture, f5j£, repeated every three or four hours, 
is extremely useful. They are considered also to possess emmena- 
gogue properties, and are employed in amenorrhoea and dy sine nor r hoe a. 
Topically, the ammoniated tincture is used as a gargle in tonsillitis and 
pharyngitis. 

Administration. — Guaiacum wood is used only as an ingredient 
in the compound decoction of sarsaparilla. Dose of guaiac, gr. x-xxx, 
in pill or emulsion, sometimes combined with alkalies. The tincture 
(tinctura guaiaci) (20 parts of the resin in 100 parts of the tincture) 
and ammoniated tincture (tinctura guaiaci ammoniatd) (10 parts of the 
resin to aromat. spt. of ammonia q. s. to make 100 parts) are much used 
in chronic rheumatism ; the former is given also in amenorrhoea ; dose, 
f5j, t. d. They should be administered in mucilage, or syrup, or 
emulsified with acacia. A lozenge may be had in the shops, contain- 
ing about 2 grains of guaiac. 

MEZEREUM. 

Description, Habitat and Properties. — Mezereum is the bark 
of Daphne mezereum and other species of Daphne (Nat. Ord. Thyme- 

* " Pharmacographia," 2d ed., p. 104, quoted. 



384 MATERIA MEDIC A AND THERAPEUTICS. 

lasaceae), European shrubs which grow to the height of four or five 
feet. The root-bark is the part employed in Great Britain, but the 
bark of our shops, which is brought from Germany, is the stem-bark # 
It comes in strips from two to four feet long and an inch or less in 
breadth, folded in bundles or wrapped in the shape of balls. It has a 
thin grayish or reddish-brown, wrinkled epidermis and a tough, 
pliable, whitish inner-bark. When fresh it has a faint, nauseous smell, 
but when dry is nearly inodorous. Its taste is at first sweetish, after- 
ward highly acrid. 

Chemical Constituents. — It yields its virtues to water and 
alcohol, and contains a neutral crystalline bitter glucoside, called 
daplinin (C 31 H 34 19 ), and a resin, to which it owes its acridity. 

Incompatibles. — Tannic and free acids precipitate the glucoside. 
The resin is insoluble in water. 

Aids. — Sarsaparilla and guaiac. 

Effects and Uses. — The local action of mezereum is irritant and 
vesicant. When swallowed in large quantities it is highly acrid ; in 
medicinal doses it promotes the action of the secreting and exhaling 
organs, particularly of the skin and kidneys. 

It is employed chiefly in conjunction with sarsaparilla (in the com- 
pound decoction and fluid extract) as an alterative diaphoretic in rheu- 
matic, syphilitic and cutaneous affections. As a masticatory \ it has been 
chewed for the relief of paralysis of the muscles of deglutition. 

Toxicology. — Christison* records a case of fatal poisoning in a 
child of 8 years by mezereum berries, but the quantity taken is not 
mentioned. Nausea and vomiting ensued, followed by narcosis. 

Administration. — The fluid extract (extractum mezerei fluidum) is 
the best preparation for internal administration ; dose, Htx. Meze- 
reum is rarely employed nowadays. 

xanthoxylum-prickly ash. 

Description, Habitat and Properties. — The bark of Xan- 
thoxylum Americanum (Nat. Ord. Rutaceae), a tree growing in the 
Northern and Southern States. It occurs in thin, curved and quilled 
fragments, the outer surface brownish-gray with black dots ; the 
inner, whitish and smooth. X. Clava-herculis resembles the former, 
having in addition corky projections and brown spines. 

Chemical Constituents. — A crystalline principle xa?ithoxyli?i, a 

* "A Treatise on Poisons," 4th ed , p. 601. 



DIAPHORETICS— SASSAFRAS. 385 

bitter substance identical with berberine, a little volatile oil, resin, etc., 
have been isolated. 

Aids. — Mezereum and guaiac. 

Effects and Uses. — Topically, it is irritant. Its taste is bitter 
and pungent. In the stomach it induces a sense of heat and some 
arterial excitement, followed by diaphoresis. 

It has been prescribed in rheumatism, and as a masticatory in 
toothache. Topically, as a counter-irritant, in female pelvic complaints. 

Administration. — Dose of the powdered bark, gr. x, 5^2 ; the 
extract is official (extr actum xanthoxyli fluidmn), dose, £5^. 

MENISPERMUM— YELLOW PARILLA ; CANADIAN MOONSEED. 

Menispermum is the rhizome and root of Menispermum cana- 
dense (Nat. Qrd. Menispermaceae), a climbing plant of North America. 
The rhizome contains berberine, starch, etc. 

Effects and Uses. — It is considered diaphoretic, diuretic, tonic, 
and alterative, and to possess virtues similar to those of sarsaparilla, 
and it may be given in corresponding doses. According to the experi- 
ments of Rutherford, it is an intestinal, but not an hepatic, stimulant. 

Administration. — Of the fluid extract (extr actum menispermi 
fliadum), the dose is f5j£-j. 

CALENDULA— MARIGOLD. 

Calendula is the Florets of Calendula officinalis, or Marigold 
(Nat. Ord. Compositae), a European plant, cultivated in our gardens. 
It contains a volatile oil, a bitter-principle, calendidin, etc. 

Effects and Uses. — It is thought to be stimulant, alterative, dia- 
phoretic, and diuretic. 

Administration. — It may be given in doses of gr. viij-5j. Of the 
tincture [tinctura calendula), the dose is f5ss-j. It may be used topi- 
cally, diluted with water 20 parts. 

sassafras. 

This is the bark of the root of Sassafras variifolium (Nat. Ord. 
Laurineae), an indigenous tree of middling size. The bark is found in 
the shops in small, irregular pieces, of a cinnamon-color, sometimes 
invested with a brownish epidermis. It has a highly fragrant odor 
and a sweetish, aromatic taste. Its virtues are extracted by water and 
alcohol, and it contains a little tannic acid and a volatile oil, (official). 

Effects and Uses. — Sassafras bark is a mild stimulant alterative- 
diaphoretic, used chiefly in combination with sarsaparilla. Its principal 
virtues are probably aromatic. 
25 



386 MATERIA MEDICA AND THERAPEUTICS. 

Administration. — Dose of the oil {oleum sassafras), gtt. ij-x. 
(For Sassafras Pith, see Demulcents^ 

STILLINGIA-QUEEN'S ROOT. 

The root of Stillingia sylvatica (Nat, Ord. Euphorbiaceae), com- 
monly called Queen's Root, a perennial plant growing to the height 
of two feet in our South Atlantic States. Its active principle has not 
been isolated. 

Effects and Uses. — The juice of the plant possesses a biting 
pungent taste, which, when swallowed, excites a feeling of warmth in 
the stomach. It augments the secretions of the gastro-intestinal tract, 
particularly the liver, also the urinary flow, and in full doses nauseates 
and purges. It is highly esteemed by Southern physicians as an 
alterative diaphoretic, in secondary syphilis, scrofula, cutaneous affec- 
tions and chronic rheumatism. 

Administration. — Dose of the powder, gr. xv-xxx. The fluid 
extract {extraction stillingia? fluidum) may be given in the dose of f oss. 
A decoction and tincture are extemporaneously prepared. 

LAPPA— BURDOCK. 

Description and Habitat. — This is the root of the Artium 
Lappa (Nat. Ord. Composite), a plant with purple flowers in pannicles, 
growing along the roadsides of our country. 

Chemical Constituents. — Inulin, mucilage, sugar, tannin, etc., 
but no starch. 

Effects and Uses. — Diaphoretic and diuretic virtues are attrib- 
uted to it. It is employed in bronchial and rheumatic affections. 

Administration. — Extraction lappa fluidum ; dose, f5/4-ij- 

ASCLEPIAS— PLEURISY ROOT. 

Description and Habitat. — The root of the Asclepias tube- 
rosa (Nat. Ord. Asclepiadeae), a perennial plant, native of Canada. 

Chemical Constituents. — A glucoside principle, tannin, gum, 
two resins, volatile matter, etc. 

Effects and Uses. — It is diaphoretic, expectorant, and in large 
doses cathartic. 

Administration. — Extraction asclepiadis fluidum ; dose, f5j^-j. 

MELISSA— BALM. 

Description and Habitat. — The leaves and tops of Melissa 
officinalis (Nat. Ord. Labiatse), a perennial plant naturalized in the 
United States. 



DIURETICS. 387 

Chemical Constituents. — A x little volatile oil, extractive, tannin, 
gum, etc. 

Effects and Uses- — A warm infusion is employed as a dia- 
phoretic. 

ORDER IV.— DIURETICS. 

Diuretics (from did, thoroughly, and oup&w, I make water) are 
medicines which excite the secretion of the urine. The flow of urine 
may be promoted indirectly by increasing the quantity of fluid taken 
into the stomach, or by the removal of causes which check its secre- 
tion, or by mental emotion, a cool temperature, or by raising the 
pressure in the arteries and by increasing the action of the heart, as by 
alcohol, etc. It is promoted directly by the use of medicinal agents 
which specifically affect the kidneys ; they are termed diuretics. A 
large proportion of diuretic medicines are found among the agents 
which influence other secretions, particularly diaphoretics. The func- 
tions of transpiration and urination are to some extent vicarious, and 
the same articles will prove diaphoretic or diuretic, as their action may 
be directed to the skin or kidneys. External warmth and warm drinks 
determine the action of such medicines to the skin ; and on the other 
hand, if the skin be kept cool, and cool diluents freely administered, 
the secretion from, the kidneys is promoted. 

Blennorrhetics, or medicines which have a special action on the 
mucous membranes, exert also a diuretic influence — probably the 
result of the stimulating impressions which they make on the mucous 
membrane of the urinary passages. When the action of the kidneys 
is obstructed by diseases of the heart, sedatives prove diuretic, by their 
tranquillizing influence on the action of the heart. In cases of obstruc- 
tion of the portal system, mercurials increase the efficacy of the diur- 
etics proper; and also cathartics, by stimulating the flow of bile and 
the pancreatic juice. 

Medicinal Uses of Diuretics. — The principal therapeutic em- 
ployment of diuretics is to promote the absorption of dropsical effusions. 
They are also useful in nephritic disorders attended with obstructed 
secretion ; to wash out calculi from the pelvis of the kidneys, ureters 
and bladder; in gravel, with the view of rendering the urine more dilute ; 
and they may be resorted to as evacuants, to reduce inflammation. 

As diuretics act by becoming absorbed, they should be adminis- 
tered in a very diluted state, to prevent a cathartic effect. 

The following groups of medicines, noticed under other heads, 
are employed also as diuretics : — 



3S8 MATERIA MEDIC A AND THERAPEUTICS. 

i 

1. The Saline and Ethereal Refrigerants (see p. 255). 

2. The Alkaline Carbonates (see Antacids) ; and the Alka HneSalts 
which contain a vegetable acid, as the acetates, citrates, and tartrates. 
The acid potassium tartrate, or cream of tartar (see p. 347), is a 
very active diuretic. 

Potassii Acetas (Potassium Acetate). — Preparation and Proper- 
ties. — This salt (KC 2 H 3 2 ), formerly termed sal diureticus from its 
decided diuretic action, is made by saturating acetic acid with potas- 
sium bicarbonate. It occurs, when pure, as a white, foliaceous, satiny 
mass, of a warm, pungent taste, very deliquescent, and wholly soluble 
in water and alcohol. 

Effects and Uses. — The physiological effects of the potassium 
compounds have already been fully considered (see p. 253). In small 
doses it is diuretic, and in larger doses gently cathartic. It is a good 
deal employed as a diuretic in dropsies (in ascites, and chronic pleurisy) , 
to cleanse the kidneys of deleterious matters in pyelonephritis, and the 
blood of biliary matters in jaundice-, as an antacid in acute rheumatism, 
as a preventive of the formation of uric acid and renal calculi, by 
neutralizing the urine. As is the case with all the alkaline salts con- 
taining vegetable acids, the acidulous radical of this salt is decomposed 
in the system into carbonic acid. Although increasing the flow of 
urine, potassium acetate diminishes the amount both of uric acid and of 
urea in the secretion. Hence it is valuable in gout, and, like colchicum, 
it may perhaps check the actual formation of uric acid in the system. 

Administration. — Dose, gr. xx-5j, repeated, in water. 

Sodii Acetas {Sodium Acetate) (NaC 2 H 3 2 +3H 2 0). — Preparation 
and Properties. — This salt is prepared from crude pyroligneous acid, 
which is saturated with cream of lime, and the solution of calcium 
acetate thus formed is decomposed by sodium sulphate ; repeated 
solution and crystallization, with fusion, furnish a pure salt in the form 
of white or colorless striated prisms, which effloresce in dry air, are 
wholly soluble in water, tolerably soluble in alcohol, and have a sharp, 
bitterish, not disagreeable taste. 

Effects and Uses. — These are analogous to those of potassium 
acetate, over which it has the advantage of not being deliquescent. 

Administration. — Dose, gr. xx-3j, in water. 

3. Sedatives (see p. 235); and Digitalis (see p. 276), which is 
very much employed in cardiac dropsies in combination with squill. 

4. Blennorrhetics (see index), particularly the oleo-resins. 

5. Most of the Stimulating Diaphoretics. 



DIURE TICS—SQ U1LL. 389 

SPECIAL DIURETICS. 
SCILLA— SQUILL. 

Description and Habitat. — Squill is the sliced bulb of Urginea 
Scilla [Nat. Ord. Liliaceae), a perennial plant which grows on the 
shores of the Mediterranean. It has fibrous roots attached to a round- 
ish-ovate bulb, from which both the leaves and flower-stem spring 
directly, the latter appearing first ; the leaves are broad, lanceolate, and 
from twelve to eighteen inches long ; the stem is about two feet high, 
and bears pale yellowish-green flowers. 

Properties and Varieties. — The fresh bulb is pyriform, of the 
size of a fist to that of a child's head, and consists of thick, fleshy, 

Fig. 45. 




URGINEA SCILLA, BULB. 

concentric scales, attenuated at their edges, and attached to a rudi- 
mentary stem ; the outer scales are very thin and papery. Two kinds 
of squill bulbs are met with, the white and the red, which differ only 
in the color of their scales, and are identical in medicinal virtues. 
Both abound in a viscid, acrid juice, which is very much diminished 
by drying, with little loss of medicinal power. For importation, squill 
is usually sliced and dried, and is found in the shops in white or yel- 
lowish white pieces, which when dry are brittle, but when moist, flexi- 
ble. They absorb moisture readily, and should be kept in well- 
stoppered bottles. They have a feeble odor, a bitter taste, and yield 
their virtues to water, alcohol and vinegar. 

Chemical Constituents. — The active principles found in squill are 



390 MATERIA MEDICA AND THERAPEUTICS. 

scillipicrin (powerfully diuretic), scillitoxin and scillin. The first two are 
said to act on the heart like digitalis, slowing the pulse by stimulating 
the end-organs of the par vagum, and the last to produce numbness 
and vomiting. A principle termed scilldin (a glucoside) is described 
by Jarmersted, * which he ascertained to be poisonous to the heart- 
muscle. 

Aids. — As an expectorant, senega and tartar emetic ; digitalis pro- 
motes its diuretic action. 

Physiological EFFECTS.---Squill has a bitter, nauseous taste. In 
large doses it excites nausea, vomiting, and occasionally purging. 
In small doses, squill promotes secretion from the mucous membranes 
and the kidneys — its diuretic effect being much the most marked and 
constant. Hammond f found that in addition to its diuretic action, 
it increased the proportion of inorganic solids. Husemann states 
that the diuretic effects of squill are due to its influence on the blood- 
pressure, which it increases ; but clinical experience teaches that it 
stimulates the kidneys. 

Toxicology and Antidotes. — In excessive doses it acts as an 
acro-narcotic poison, gr. xxiv % having proved fatal. The symptoms 
are violent vomiting and purging, abdominal pains, bloody or sup- 
pressed urine, reduction of the pulse, with collapse ; or death may be 
preceded by convulsions. Christison § describes an instance in which 
a teaspoonful of the root killed a woman, the chief symptoms being 
gastric pain and convulsions. The stomach was found to be inflamed 
everywhere, and partly eroded. After evacuation of the stomach, 
opiates and demulcents are to be administered, and, if syncope or col- 
lapse occur, alcoholic stimuli should be given. 

Medicinal Uses. — Squill is prescribed chiefly in the treatment 
of dropsy; it should not be used, however, in cases complicated with 
degeneration of the kidneys or inflammation of the bladder. Digi- 
talis is much prescribed in combination with squill in the treatment 
of cardiac dropsies, and calomel is often added with a view to its 
action on the absorbents. As a blemiorrhetic expectorant, squill is an 
excellent remedy in chronic and acute bronchial affections ; it is, how- 
ever, improper in the early stages of inflammatory cases, or until 
expectoration is established. As an emetic, squill is too dangerous for • 

* Arch, filr exper. Pathol, u. Pharmak., XI, p. 22. 
f Am. Journ. Med. Scl, 1859, p. 275. 
J"Handbuch der Toxicologic," p. 413. 
I " A Treatise on Poisons," 4th ed., p. 879. 



DIURETICS— COLCHICUM. 391 

general use ; but it forms an ingredient in some emetic preparations 
administered in croup. 

Administration. — Dose, as a diuretic or expectorant, gr. j in pill 
form, repeated and gradually increased till nausea supervenes. Grains 
vj-xij will induce emesis. Of the vinegar {ace turn scillce, containing 10 
per cent, by weight of the powder), the dose is TTLxv to f5ij; of the 
fluid extract {extractum scillce fluidurn), TTL j ; of the syrup {syrupus 
scillce), f5j ; of the compound syrup {syrupus scillce compositus), known 
as hive syrup (which contains the fluid extracts of senega and squill, 
calcium phosphate, and tartar emetic, gr. j in every ounce of the 
syrup), 1ftv-f5j, according to the age; of the tincture {tinctura scillce) , 
TTLv-xxx ; the last three are excellent preparations in the latter stages 
of acute bronchitis. The liquid preparations may be prescribed diluted 
with glycerin. 

COLCHICUM. 

Colchici Radix, Colchicum Root ; Colchici Semen, Colchicum Seed. 

Description and Habitat. — Colchrcum autumnale, or Meadow- 
Saffron {Nat. Ord. Liliaceae), is a small biennial, bulbous plant, which 
grows wild, in moist meadows, in England and other temperate parts 
of Europe. The bulb, or corm, appears in midsummer as the lateral 
offset from the corm of the preceding year, and sends up the flower- 
stem in the autumn — the leaves and fruit following in the succeeding 
spring. The leaves are broadly lanceolate, about five inches long; the 
flowers, of a lilac or light-purple color; and the fruit oblong, elliptical 
and three-celled. 

Properties. — The corm and seed are the portions used medi- 
cinally. The corms are gathered in July, just before the sprouting of 
the flower from the young corm. They are somewhat like tulip-bulbs 
in appearance, but solid, and not composed of scales. They are 
covered by an external brown membrane and an inner reddish-yellow 
one, and are an inch and a half to two and a half inches in length, 
with a longitudinal groove. Internally they are white, fleshy and 
solid, and contain an acrid, bitter, milky juice. As found in the shops 
they are in the dried state, sometimes whole, but usually cut into 
transverse slices, about an eighth of an inch thick, with a notch on one 
side, and deprived of the outer brown membrane. They have a hircine 
odor and an acrid taste. The seeds are brown, about the size of 
black-mustard seed, inodorous, and have a bitter taste ; they are less 
apt to be injured by drying than the corm. 

Chemical Constituents and Tests. — Colchicum corm and seeds 



392 MATERIA MEDICA AND THERAPEUTICS. 

yield their virtues to vinegar and alcohol ; they both contain an 
amorphous alkaloid, soluble in water, readily so in alcohol, but 
insoluble in ether, termed colchicine (C 21 H 22 (OCH 3 )N0 5 ). Colchicein 
(CsiH^OHJNOg) is a product of the hydrolysis of colchicine. Both 
are poisonous. Tests. — Colchicine makes with concentrated nitric 
acid a play of colors, beginning with yellow, then green, afterward 
crimson, and finally violet ; with concentrated sulphuric acid, to which 
has been added a fragment of potassium nitrate; it produces an 
intensely yellow color terminating in light violet. 

Incompatibles. — Tannic acid, and the vegetable infusions con- 
taining it, form a partly insoluble tannate with colchicine. 

Fig. 46. 




COLCHICUM AUTUMNALE, BULB. 

Aids. — Squill ; also the purgatives, and diuretics, as colocynth 
and digitalis. 

Physiological Effects. — Colchicum is a local irritant. Col- 
chicine is undoubtedly the active ingredient of .meadow-saffron 
(Husemann*), and when introduced by the stomach diffuses into the 
blood, since it has been found in the heart, lungs, liver, kidneys and 
blood by Aschoff.f Other observers, however (Laborde et Houde) J, 
failed to detect it there or in the heart, even after intravenous injec- 
tion, but found the largest quantity inside the stomach and intestines. 
It seems to expend its force on the alimentary tract, though not 

*"Die Pflanzenstoffe," 1871, p. 497. 
f " Die Pflanzenstoffe," 1871, p. 499. 
\ Pamphlet, 1887. " Le Colchique et la Colchicine." 



DIURETICS— COL CHICUM. 393 

entirely by a local action, for both Lewins * and Roy f found this 
part to be much inflamed after the subcutaneous administration of 
the drug. The taste of the seed and corm is bitter and acrid. Taken 
internally \ in small doses, it stimulates the secretions generally ; that 
of the liver is augmented and rendered watery ; in large doses it pro- 
duces nausea, vomiting,! and repeated purging, and primarily accelera- 
tion, followed by a reduction in the frequency of the pulse. In exces- 
sive doses it is an intestinal irritant poison, inducing emesis, uncon- 
trollable diarrhoea, collapse, and finally destroying life by paralysis of 
respiration, the heart beating for a short time after the cessation of this 
act; the cerebral functions usually remain unaffected, though Toul- 
mouche (loc. cit.) states that there is decided cerebral excitement. 
According to the recent investigations of Laborde et Houde (loc. cit) 
colchicine is without action on the centres of intelligence or volition, 
and there is an entire absence of paralysis, either motor or sensory, of 
central origin. The temperature falls during the period of emeto- 
catharsis ; and when injected into dogs there is a marked fall in the 
blood-pressure. The amount of urea and uric acid excreted in the 
urine is much increased after the administration of colchicum. Lewins 
{loc. cit.) found the urea to be almost doubled. Hammond § experi- 
mentally ascertained that it heightened the urinary flow and the pro- 
portion of solids, but as his results were based on only three analyses 
they can scarcely be accepted as conclusive. Although placed among 
the diuretics colchicum does not evince a more decided action on the 
kidneys than on other secretions, as those of the skin, liver, and 
mucous membranes. 

Toxicology. — Dr. Major || reports 17 cases of poisoning by the 
wine of colchicum seeds, seven of which were fatal, the quantity 
ingested ranging from f§iij-viij; in two, there were convulsions. Dr. 
G. B. Wood If states that f5iiss of the wine of the root proved fatal, 
and in another instance f§iss** of the wine of the bulb killed a man. 
Vomiting and purging are the chief symptoms of colchicum poisoning, 
convulsions being infrequent, while the brain escapes till the approach 



* Edinburgh Med. and Surg, your., LVI, p. 185. 
f Arch, de Physiol. Norm, et Pathologique, t. V. p. 648. 
J Arch. Gen. de Medicine, t. XVIII, p. 37, par A. Toulmouche. 
\ Amer. Journ. Med. Sci., 1859, p. 275. 
|| Canada Med. and Surg. "Journ. , 1874, p. 24. 
^[''U. S. Dispensatory," 15th ed., p. 1534. 
** Edinburgh Med. and Surg. Journ., XIV, p. 262. 



394 MATERIA MEDICA AND THERAPEUTICS. 

of death. After death, in Roy's {loc. cit) experiments upon dogs, the 
post-mortem appearances were those of enteritis. 

Antidotes. — Tannic acid is a partial antidote (forms a white pre- 
cipitate with colchicine) ; emetics, if required, and opiates, demulcents 
and stimulants are to be given. 

Medicinal Uses. — Colchicum has long enjoyed a high reputation 
in the treatment of gout; and, although its modus medendi is obscure, 
though probably a cholagogue one, it is universally admitted to possess 
a more decided control over the disease than any other remedy. It is 
usually administered in repeated doses till an effect is produced on the 
bowels, though purging does not promote its curative effect. Epsom 
salts and magnesia arc often combined with it, as in the celebrated 
Scudamore } s draught (magnesia, gr. xv-xx ; magnesium sidphate, 5j-ij ; 
wine of colchicum seed, f5j-ij, in any pleasant vehicle). An excellent 
combination in the treatment of gout is colchicum {wine of the seed, 
foj), with potassium iodide (3ij), dissolved in cinnamon-water (foviij); 
dose, foss t. d. until purgation is produced. Quinine and digitalis are 
also often given advantageously, with colchicum, in gout.* When it 
is desired to act on the kidneys and skin rather than the bowels, 
opiates are sometimes added. It is better to reserve colchicum for the 
treatment of the acute paroxysms of gout, giving a little opium (as in 
Dover's powder) at night, particularly to relieve the pain and procure 
sleep, enjoining perfect rest and quiet and using warm applications 
locally. In chronic gout and in the uric acid diathesis colchicum is not 
as useful, and these conditions are better treated by a properly regu- 
lated diet, avoidance of stimulants, exercise in the open air and the 
administration of the alkalies, particularly of the lithium salts. 

Administration. — Dose of the corm or seed, in powder, gr. 
ij-viij ; the seeds are to be preferred. The liquid preparations, 
which have displaced the powder, are: the wine of the root {vinum 
colchici radicis), (the most in use), TTLx-xxx; wine of the seed {vinum 
colchici seminis), dose, f5ss-j; tincture of the seed {tinctura colchici semi- 
nis), dose, f5ss-j. An extract of the root (acetic), {extractum colchici 
radicis), is also employed — dose, gr. j-ij ; and a fluid extract of the seed 
{extractum colchici semi?iis fluiduni), and of the root {extractimi colchici 
radicis fluidum) — dose, gtt. iv-xij. The alkaloid colchicine (not official) 



* Lartigue's celebrated gout-pills are : acetic extract of colchicum root, 2 grains ; ex- 
tract of digitalis, I grain; compound extract of colocynth, 20 grains, to be mixed and 
divided into five pills — one to be taken at night. 



DIURETICS— CANADIAN HEMP. 395 

has been recommended as the best form of administration in doses of 
gr. to in granules, or somewhat less by hypodermic injection. 

OLEUM ERIGERONTIS— OIL OF ERIGERON. 

Description and Constituents. — The oil distilled from the fresh 
flowering herb of Erigeron canadense, or Canada Fleabane (Nat. Ord. 
Composite), an herbaceous indigenous plant, one to five feet high, 
with linear leaves, and white, insignificant rayflorets. The oil consists 
chiefly of dextrogyrate, limonene, with a small amount of an undeter- 
mined substance. 

Effects and Uses. — It possesses diuretic and slight hemostatic 
properties, and has been employed in uterine hemorrhage. It has been 
given in gonorrhoea with success, Stark* stating that in the majority 
of cases it stopped the discharge in from two to six days. Prettymanf 
reports unvarying success with it in 50 cases, affirming that it cures in 
from six to eight days, but as he omits the details of treatment, his 
statement cannot be accepted as proven. 

Administration. — Dose, gtt. v-xx, on sugar, or in capsule. 

apocynum-canadian hemp. 

Description and Habitat. — Apocynum cannabinum, or Canada 
Hemp [Nat. Ord. Apocynacese), is an indigenous herbaceous plant 
growing to the height of two or three feet, with oblong-ovate leaves 
and small greenish, campanulate flowers. 

Properties. — The root is the official portion; it is of a yellowish- 
brown color when young, and of a dark-chestnut when old, has no 
odor, but a nauseous, acrid, bitter taste. The fresh root, when 
wounded, pours out a milky juice, whence the plant is sometimes 
termed milk-weed. 

Chemical Constituents. — Although the entire root is official, 
the bark of the root is probably alone active. It yields its virtues to 
water and alcohol, and contains gallic and tannic acids, gum, resin, 
apocynin, apocynein, bitter-extractive, etc. 

Effects and Uses. — Canadian Hemp is diuretic, diaphoretic, seda- 
tive, and, in continued doses, emeto-cathartic. It has been shown J to 
possess a decided cardiac sedative action, analogous to that of digitalis ; 

* London Med. Record, June 15th, 1 886, quoted. 

f Amer. Journ. Med. Set., 1886, p. 117. 

X Therapeutic Gazette, Sept. 15, 1889. Geo. R. Murray. 



396 MATERIA MEDICA AND THERAPEUTICS. 

but without its corresponding elevation of blood-pressure. It is chiefly 
employed in the treatment of dropsy, in which its action is often pow- 

Fig. 47. 




APOCYNUM CANNABINUM. 



erfully efficacious. It should be given in amounts just sufficient to 
produce diuresis, when a cathartic effect is not desirable. 

Administration. — A good form of exhibition is an infusion (5ss 
to boiling water Oj, or the same amount may be dissolved in gin Oj) ; 
dose, f 5ij-iv, three or four times a day. The fluid extract (extractum 
apocyni fltddutri) has been added to the U. S. P. of 1890 ; dose, f5/^. 

TARAXACUM— DANDELION. 

Description and Habitat. — Taraxacum Dens-leonis, (Nat. Ord. 
Compositae), is a small herbaceous, perennial plant, common to most 
parts of the world, and found abundantly throughout the United States. 



DIURE TICS— CO UCH- GRASS. 397 

Properties. — It has a fusiform root, which sends up numerous 
long, sinuated, bright-green leaves, and flower-stems about six inches 
high, bearing golden-yellow flowers. The root is the official portion, 
and should be gathered in the autumn. In the fresh state it is several 
inches long, branched, fleshy, of a light-brown color externally, whitish 
within, and abounds in a milky juice ; the fresh root is preferable 
for use. When dried it is shrunken, wrinkled and brittle. It is with- 
out smell, but has a bitter taste. 

Chemical Constituents. — Boiling water extracts its virtues, 
which probably depend on a peculiar bitter crystallizable principle 
termed taraxacin, soluble in water and alcohol. It also contains tar- 

Fig. 4 8 - 




TARAXACUM DENS-LEONIS. 

axacerin, resin, and Dragendorff* found inulin (C 6 H 10 O 5 ) 2 and some 
sugar. 

Effects and Uses.— Taraxacum is diuretic, slightly aperient, 
with some cholagogue action. It is useful in hepatic dropsies, and is 
also employed in dyspepsia accompanied by derangement of the liver. 

Administration. — Extract (extractum taraxaci) — dose, gr. xx-5j, 
in pills, t. d. ; fluid extract (extractum taraxaci fluidum) — dose, f 5j~ij, t. d. 

TRITICUM— COUCH-GRASS. 

Description, Habitat and Constituents. — The rhizome of Agro- 
pyrum repens or Couch-grass {Nat. Ord. Graminese), a perennial 
weed, native of Europe and North America, growing in fields and 
waste places, with a long, stiff, pale-yellow rhizome, which should be 

* " Pharmacographia," 2d ed., p. 394, quoted. 



398 MATERIA MEDICA AND THERAPEUTICS. 

gathered in the spring. It is found in the shops, freed from the root- 
lets, cut into short lengths and dried, without odor, but having a 
slightly sweetish taste (Fluckiger and Hanbury), containing triticin 
(which resembles inulin), and several sugars. 

Effects and Uses. — Couch-grass appears to be a feeble diuretic. 
According to Sir H. Thompson,* it exercises a beneficial influence in 
chronic cystitis. He directs the decoction ,to be made by boiling 
oij-iv in water Oij until reduced to Oj ; the strained liquor to be taken 
in four doses in 24 hours. Whitla, too, advises it to allay irritation of 
the urinary passages. 

Administration. — The fluid extract (extractum tritici fluidum) 
may be given in doses of f5ss-j. 

JUNIPERUS— JUNIPER. 

Description and Habitat. — The fruit or berries of Juniperus 
communis (not official) {Nat. Ord. Coniferse), an evergreen European 
shrub, naturalized in the United States, are used as adjuvants to the 
more active diuretics, and in large doses produce strangury and 
bloody urine, and prove emmenagogue. When dried they are about 
the size of a pea, of a blackish-purple color, and a sweetish, terebin- 
thinate, aromatic taste ; they are given in infusion. 

Chemical Constituents. — Their virtues depend on a volatile oil 
(oleum juniperi) (C 10 H 16 ). 

Effects and Uses. — Hammond f found that juniper increased 
the flow of urine, the proportion of solids being only slightly altered 
(three experiments). Juniper is employed as a diuretic in the dropsy of 
cardiac, hepatic and chronic renal maladies. Being a stimulant-diuretic, 
it is not adapted to acute affections of the kidneys. 

Administration. — The compound spirit (spiritus juniperi composi- 
tus) contains the oils of juniper, caraway and fennel, dissolved in 
alcohol and water ; is a pleasant addition to stimulating, diuretic and 
blennorrhetic combinations, and a good stomachic and carminative ; 
dose, f5j-ij. The spirit (spiritus juniperi) is made by dissolving 5 parts 
of the oil in 95 parts of alcohol ; dose, f oj— ij ; of the oil (oleum juniperi) 
gtt. v-x, t. d., in capsules. An active diuretic mixture is: 3^ Potassii 
bitartratis, 5ij ; seminis juniperi, oj ; aquae (tepid), Ojv. M. Sig. — All 
to be taken in 24 hours. Serviceable in removing the dropsy of hy- 
drothorax, ascites, zircemia, chronic pleurisy, and Bright 's disease. 

*" Diseases of the Urinary Organs," 7th edition, p. 152. 
I Amer. Jour. Med. Sci., 1859, p. 275. 



DIURETICS— CANTHARIDES. 399 

SCOPARIUS-BROOM. 

Description and Habitat. — Cytisus Scoparius (Nat. Ord. Legu- 
minosae), is a common European shrub, cultivated in the United States, 
from three to five feet high, with numerous bright-yellow flowers. 
The tops of the branches are the official portion, but the seeds are also 
used. The twigs are pentangular (with small oblong, downy leaves), 
of a bright-green color, a strong, peculiar odor when bruised, and a 
bitter to nauseous taste. 

Chemical Constituents. — Two principles are found in broom- 
tops — scoparin (C 21 H 22 O 10 ), a neutral, crystallizable body, the diuretic 
constituent, and a volatile poisonous alkaloid, sparteine (C 15 H 26 N 2 ), [see 
p. 283) ; it also contains volatile oil, tannin, etc. 

Effects and Uses. — Broom is an efficient diuretic, in large doses 
producing free purging. It is a valuable and reliable remedy in dropsy, 
hydrothorax, chronic Bright 's disease and urcemia, best given in decoc- 
tion, half an ounce to a pint of water, boiled down to half a pint, of which 
an ounce may be given every hour or two till the bowels are disturbed. 

Administration. — A fluid extract (extractum scoparii fluidimi) is 
used in doses of f5ss-j ; an infusion is prepared, dose, f Sj- 

zea-corn-silk. 

Description, Habitat and Properties. — This is the styles and 
stigmas of Zea Mays (Nat. Ord. Graminese), which is cultivated in all 
temperate countries. They are thread-like, silky, hairy, about 15 Cm. 
long and 0.5 Mm. broad, and inodorous. The official portion should 
be gathered when the tassel has shed its pollen. 

Chemical Constituents. — Tannin, resin and fixed oil are found 
in corn-silk. 

Effects and Uses. — The taste of Corn-silk is sweetish. It in- 
creases the urinary flow * and has been given with advantage as a diu- 
retic and demulcent in renal calculi, ammoniacal urine, and chronic 
cystitis. 

Administration. — Of the fluid extract, fSss-ij, may be given; or 
of the infusion, freshly made, foij ; neither are official. 

CANTHARIS— CANTHARIDES. 

The properties, etc., of cantharides will be noted fully under the 
head of Irritants (subdivision Epispastics). Taken internally, they 

* Therap. Gazette, 1882, 3, 7; Proceedings Naval Med. Soc, Vol. 1, No. 2. 



400 MATERIA MEDIC A AND THERAPEUTICS 

sometimes prove diuretic, and generally excite irritation of the genito- 
urinary passages, which is shown by strangury, priapism, etc. ; and in 
over-doses act as an acro-narcotic poison. They are employed in dropsies, 
incontinence of urine, amenorrhcea, seminal weakness, impotence, etc. 

Administration. — Dose, gr. j-ij twice a day, in pill. They are 
most commonly administered in tincture (tinctura cantharidis) (5 per 
cent.) ; dose, gtt. x or more, three or four times a day, till signs of 
strangury supervene. 

SAMBUCUS— ELDER. 

A decoction of the flowers of the Sambucus Canadensis (Nat. 
Ord. Caprifoliaceae), is believed to be mildly diuretic and cathartic. 

ORDER V.— BLENNORRHETICS. 

Blennorrhetics (from ^Xivva, mucus, and piw, I flow) are medicines 
which promote the secretion of the mucous membranes. They are 
employed therapeutically in morbid conditions of those membranes, 
with a view to the restoration of healthy action in cases of deficient, 
abnormal or excessive secretion. 

When administered with the object of stimulating the secretion 
of mucus from the bronchial or laryngeal membrane, this class of 
agents is termed expectorants. They are prescribed in the subacute 
and chronic forms of bronchitis and laryngitis, and in the declining 
stages of the acute forms of those affections and of pneumonia. In 
the early or inflammatory stages of acute bronchitis and laryngitis 
the stimulating expectorants are inadmissible until expectoration has 
bee'n established. 

The blennorrhetics are less employed in gastro-enteric affections 
than in those of other mucous membranes, owing to their tendency 
to produce catharsis. Several of the oleo-resins are, however, used 
with advantage in certain forms of chronic diarrhcea, and the oil of 
turpentine is highly esteemed in the treatment of the diarrhcea of ty- 
phoid fever. 

The oleo-resinous articles of this group are extensively employed 
in diseases of the urino-genital mucous membranes — gonorrhoea, gleet, 
leucorrhoea, incontinence of urine and cystitis. 

The following are the articles chiefly resorted to for their influ- 
ence on the mucous membranes : — 

SENEGA. 

Description and Habitat. — Polygala Senega, or Senega Snake- 
root {Nat. Ord. Polygaleae), is a small indigenous plant, found in all 



BLENNORRHETICS— SENEGA. 



401 



parts of the United States, but most abundantly in the South and 
West It has a perennial branching root, several erect annual stems 
about a foot in height, alternate lanceolate leaves, and small whitish 
flowers arranged in a terminal spike. 

Properties. — The root is the official portion. It occurs in the 
shops in twisted pieces, varying in thickness from the size of a quill to 
that of the little finger, attached to a knotty head, and marked with 
a ridge along their whole length and numerous annular protuberances. 
The cortical portion is hard, resinous, of a yellowish-brown color, 

Fig. 49. 




POLYGALA SENEGA. 

and contains the active qualities of the root. The central ligneous por- 
tion is white and inert. The odor of senega is peculiar and disagree- 
able, but faint in the dried root ; the taste is at first mucilaginous and 
sweetish, but afterward becomes acrid and very irritating. 

Chemical Constituents. — The virtues of senega are extracted by 
cold and hot water and alcohol. It contains polygalic acid (senegin), 
on which its activity chiefly depends ; this is identical with saponin, a 
glucoside found in soapwort and other plants (Huseman*). 

Effects and Uses. — Senega, in small doses, is an active excitant 



*"Die Pflanzenstoffe," 1871, p. 750. 



26 



402 MATERIA MEDICA AND THERAPEUTICS. 

of the mucous membranes and secretions generally, and in large doses 
proves emetic and cathartic. 

It is prescribed chiefly as a stimulating expectorant in chronic and 
subacute bronchial affections, and in the latter stages of acute bronchitis 
and pneumonia. As an ingredient in the compound syrup of squill it is 
employed in the treatment of croup, but, except in some such combina- 
tion with tartar emetic or other nauseant emetic, it is scarcely admis- 
sible in the early stages of this disease. Senega is thought also to 
possess emmenagogue properties, and it is highly extolled by many 
practitioners in the treatment of cwnenorrhcea, and has been occasionally 
used as a diuretic in dropsies. 

Administration. — Dose, in powder, gr. x-xx. The fluid extract 
(extr actum senega fluidmn), is given in the dose of Tftx-xx ; and syrup 
(syrupus senega) is also used, in the dose of fSj-ij ; often diluted with 
glycerin. 

QUILLAJA-SOAP-BARK. 

Description and Habitat. — Quillaja is the inner bark of the 
Quillaja Saponaria (Nat. Ord. Rosaceae), a tree of South America. 

Properties. — The bark is found in the shops in large flat pieces, 
brownish-white, with small patches of brownish cork on the outer 
surface, but otherwise smooth ; without smell, but having an acrid 
taste. 

Chemical Constituents. — It contains saponin (C^H^O^, a gluco- 
side), which in watery infusion foams like soap, and is identical with 
polygalic acid (senegin). 

Physiological Effects. — The following statement concerning 
saponin is based on the investigations of Lhomme * and Kobert.f 
According to the latter observer, saponin consists of at least four 
organic substances, viz., of pure saponin (C^H^O^, inert), lactosi?i 
(inert), quillaiic acid (C 19 H 30 O 10 ) and sapotoxin — the last two powerfully 
poisonous. The principle experimentally used by Lhomme seems to 
have been a mixture of these substances. Locally, it is a protoplasmic 
poison, and applied to the skin with friction is irritant, and if it be con- 
tinued, will cause suppuration. Brought in contact with the nose and 
throat, its dust produces violent sneezing and coughing ; applied to 
the conjunctiva it causes pain, swelling and a flow of tears. Large 
doses produce vomiting and diarrhoea. It abolishes instantly the ex- 

* Pamphlet, "Etude exper. sur Taction physiol. de la saponine." 

f Arch. f. exper. Pathol, u. Pharmak., 1887; also Am. J. Pharm., March, 1889, 
quoted. 



BLENNORRHETICS— GARLIC. 403 

citability of the striated muscles and nerves when in contact with 
them. Applied directly to the heart it rapidly stops it in diastole, and 
antagonizes the effect of digitalis upon it. Kobert ascertained, his ex- 
periments being made with quillaiic acid, that when injected into the 
veins of dogs, and also by the stomach, it expended much of its force 
upon the alimentary canal, which was found to be in a highly inflamed 
condition. Both he and Lhomme found that when introduced into 
the veins in sufficient quantity it paralyzed voluntary motion, abolished 
the reflex excitability of the cord, lowered the blood-pressure, and 
gradually stopped the heart's beats. By ingestion it is much less toxic. 
Lhomme observed, without making exact experiments, that the 
urinary and dermal secretions were considerably diminished in frogs, 
rabbits and rats. Schroff noticed an increase of the bronchial mucus. 

Medicinal Uses. — Quillaja is rarely employed medicinally, nor 
are its exact therapeutical uses yet placed on a scientific basis. As an 
expectorant in chronic bronchitis, emphysema and dilatation of the 
bronchi, it has been highly recommended (Kobert*). It is contra- 
indicated where a disposition to haemoptysis is present (A. Maslovskif), 
and in inflammatory conditions of the alimentary tract. It is chiefly 
useful from the property it possesses of emulsifying oils. 

Administration. — Dose, gr. xv-xxx in infusion, t. d. A fluid 
extract mixed with glycerin forms an admirable local application to 
some cases of acne (Piffard). The tincture is official (tinctura qnillajce) ; 
f5j represents gr. x of the drug. The liquid preparations must be 
taken largely diluted. 

ALLIUM— GARLIC. 

Description and Habitat. — Allium sativum (Nat. Ord. Liliaceae) 
is a small perennial, bulbous plant, which grows wild in the South of 
Europe, and is cultivated in all parts of the world. 

Properties. — The bulb is the portion used. As found in the 
shops, it is somewhat spherical in form, about an inch in diameter, 
with the portion of the stem attached, covered with a white, mem- 
branous envelope, and consists of five or six smaller bulbs, of a curved, 
oblong shape, called cloves of garlic. They have a strong, irritating, 
characteristic odor and a bitter, acrid taste. 

Chemical Constituents. — Water, alcohol and vinegar extract 
their virtues, which depend on an essential oil, which is of a yellow 
color, very volatile and irritating ; it consists of various sulphur com- 
pounds of ally I (C 3 H 5 ), propyl (C 3 H 7 ), etc. 

* Central./. Klin. Med., No. 30, 1885. f Russ - Meditz., No. 36, 1886, p. 599. 



404 



MATERIA MEDICA AND THERAPEUTICS. 



Effects and Uses. — Garlic is a local irritant and rubefacient; 
taken internally, it quickens the circulation and stimulates the secre- 
tions generally. It is employed as an expectorant in chronic and acute 
bronchitis, particularly in infantile cases, and occasionally as a stomachic 
in flatulence \ and as a diuretic in dropsies. Topically it is used as a 
rubefacient. 

Administration. — A clove may be swallowed entire, or cut into 

Fig. 50. 




GARLIC— BULBS. 



small pieces. Dose of the fresh bulbs, oj-ij, in pill ; of the juice, f5ss, 
mixed with sugar ; of the syrup (syrupus allii), f5j, for children. 

SCILLA-SQUILL. 

Squill, already noticed among Diuretics, is one of the most power- 
ful and valuable stimulating expectorants in the Materia Medica. (For 
properties, doses, preparations, etc., see index for scilla.) 



TEREBINTHINA-TURPENTINE. 

Description, Habitat and Varieties. — The term turpentine is 
applied to a concrete oleo-resin obtained from certain species of pinus. 
Two kinds of turpentine are recognized by the U. S. Pharmacopoeia; 
I. The common American white turpentine {terebintliina), which is pro- 
cured chiefly from Pinus australis {Nat. Ord. Coniferae), a large indi- 
genous evergreen tree of our Southern States, where it is called Long- 



BLENNORRHETICS— TURPENTINE. 405 

leaved Pine, Yellozv Pine, and Pitch Pine ; and in part also from Pinus 
taeda, found in Virginia, and other species of Pinus. 2. Canada tur- 
pentine (Terebinthina canadensis), kept in the shops under the name of 
Canada balsam or balsam of fir, the product of Abies balsamea, the 
American Silver Fir or Balm of Gilead Tree, (Nat. Ord. Coniferae), a 
handsome tree about forty feet in height, inhabiting the northern por- 
tions of North America. Many other varieties of turpentine are 
known in commerce, as Bordeaux turpentine, Venice turpentine, Chian 
turpentine, etc. 

Preparation and Properties. — White turpentine comes from 
North Carolina and other Southern States, and is collected from exca- 
vations (called technically " boxes " *) made in the trunks of the trees, 
from March to November, into which the turpentine runs in the mild 
weather. It is yellowish-white and somewhat translucent, semi-fluid 
in summer, firm and hard in winter, but becoming permanently hard 
by exposure to the air, and has a peculiar aromatic odor and a warm, 
pungent, bitterish taste. Canada turpentine comes from Canada and' 
Maine. It is procured by breaking the vesicles which are found 
between the bark and wood of the trees and collecting the liquid con- 
tents in a bottle. When fresh it has the consistence of honey, but 
gradually solidifies by age. It is yellow, transparent, tenacious, of a 
peculiar, pleasant, terebinthinate odor and an acrid taste. 

Chemical Constituents. — The turpentines yield, by distillation, 
a volatile oil known as oil of turpentine (15-30 per cent.), and leave 
a residue consisting exclusively of resin. Both the oil (see p. 406) and 
resin (see index) are official. The turpentines are inflammable, nearly 
insoluble in water, but almost wholly soluble in alcohol and ether. 

Physiological Effects. — The local operation of the terebin- 
thinates is irritant. When applied to the skin they produce a rubefa- 
cient effect. The taste of turpentine is peculiar and bitter. The 
activity of the terebinthinates depends on their volatile oil, the resin 
seems to be inert, or it may be excites intestinal peristalsis. Taken 
internally, in small doses, they are absorbed, and prove excitant to 
the vascular system and the secretions generally, especially the 
mucous membranes ; they communicate an odor of violets to the urine. 
When swallowed in large doses they promote the peristaltic motion 
of the intestines. In large doses they cause pain in the loins, stran- 
gury and bloody urine. 

* " Our Slave States," 1856, p. 339, F. L. Olmsted. 



406 MATERIA MEDICA AND THERAPEUTICS. 

Medicinal Uses. — Turpentine is employed chiefly in diseases of 
the various mucous membranes, as gonorrhoea, gleet, leucorrhoea, chro7iic 
bronchitis and chronic mucous diarrhcea, and, in cathartic doses, in cases 
of thread- and tape-worms. 

Administration. — Dose, as a blennorrhetic, gr. xx-5j, in pill or 
capsule ; as an antlielmintic or cathartic, Sss-j in emulsion. When 
turpentine is to be prescribed the oil is the form usually selected. 

Oleum Terebinthinae [Oil of Turpentine) commonly called spirit of 
turpentine, is the active principle of turpentine, obtained by distillation. 

Properties. — It is a limpid, colorless, volatile and inflammable 
liquid, of a strong, penetrating, peculiar odor and a bitterish taste ; 
very slightly soluble in water, less soluble in alcohol than the volatile 
oils generally, and wholly soluble in ether; exposed to the air it 
absorbs oxygen, with the formation of resin. Its effects and medici- 
nal uses are the same as those of turpentine, for which it is usually 
substituted in practice. Rectified oil of turpentine [oleum terebinthince 
'rectificatum) is the preparation directed by the U. S. P. to be dispensed 
when oil of turpentine is required for internal use. 

Aids. — Its effects are enhanced by the alcoholic and diffusible 
stimuli, and by copaiba, cubebs and sandal wood oil. 

Contraindications. — In cardiac hypertrophy, atheroma of the 
vessels, and acute renal inflammation. 

Physiological Effects. — Turpentine oil is germicidal. Locally, 
it acts as a rubefacient and counter-irritant. The inhalation of its fumes 
in sufficient quantity proves irritant to the air passages and eyes. Its 
taste is hot, pungent and bitterish. It produces a burning feeling in 
the mouth with increased salivary flow. A medicinal dose is followed 
by slight epigastric pain. It rapidly diffuses into the blood, since it 
has been found in the tissues and is detectable on the breath. When 
swallowed in large doses, as fSj-ij, it commonly passes off by the bowels 
accompanied by burning pain and gastro-intestinal disturbance ; taken 
in small doses, it is absorbed. Medicinal doses stimulate into action 
the intestinal movements accompanied by the discharge of faecal 
matter and gases. According to the investigations of Hare,* it 
increases the number of the cardiac beats, due to a direct action on 
the heart; large doses decidedly slow the pulse by stimulation of the 
vagus inhibitory centre. Its influence, either in large or small amounts, 
is indifferent upon the vaso-motor centre, though this statement is not 

* Med. News, Phila., 1887, II, p. 593. 



BLENNORRHETICS— TURPENTINE. 407 

in accord with that of Kobert.* Small doses increase reflex action, 
while large decrease it ; the first being due to stimulation, and the 
latter to depression of the cord and afferent nerves. Respiration is at 
first increased, but afterward diminished as to frequency. Urine : 
when given in moderate doses it stimulates the kidneys, augmenting 
the urinary flow. In large amounts (f§ij), the urine is diminished, 
often bloody and sometimes suppressed. Toxic quantities provoke 
constant efforts at micturition, strangury, and often priapism. Elimi- 
nation : by the broncho-pulmonary mucous membrane and kidneys 
(chiefly). 

Toxicology and Antidotes.— The lethal dose is not determined, 
but poisonous effects from the oil. of turpentine are rare, as it generally 
passes off by the bowels ; it may, however, produce severe vomiting 
and purging, bloody or suppressed urine, intense irritation of the 
urino-genital organs, unconsciousness, with dilated pupils, and even 
death. Toxic amounts destroy life by causing cardiac failure. An 
infant f swallowed fo/^, but recovered after convulsions. Its toxic 
effects may be antagonized by emptying the stomach and the admin- 
istration of anodynes and demulcents. Physiologically it is antago- 
nized by the cardiac depressants, as aconite. 

Medicinal Uses. — In large doses it is employed as an anthel- 
mintic (see anthelmintics) and cathartic, and is much used as a clyster 
for the relief of tympanites. In small doses it is prescribed in chronic 
discharges and haemorrhages from the various mucous membranes; 
in the latter stages of typhoid fever, where the abdomen is tympanitic 
and the tongue dry ; as a combined stimulant and blennorrhetic ; as a 
stimulant in typhus fever % and purpura ; and in nephritic disorders, as 
pyelonephritis. As a rubefacient, it is a valuable counter-irritant in 
numerous diseases, as in affections of the joi7its, in chronic rheumatism, 
and it should usually be applied with gentle friction. Turpentine- 
stupes are highly efficacious in bronchial catarrhal affections, and in 
the relief of the tympanites and the abdominal pain of typhoid fever. 
For the relief of the meteorism of typhoid, an enema of turpentine oil 
maybe given. 

Administration. — Dose, gtt. v-xxx, repeated, as a blennorrhetic 
stimulant; io%-], as a cathartic enema or anthelmintic against round 

* Arch. fur. Anat. u. Physiol. , 1886, — quoted, 
f London Med. Times, 1 851, p. 380. 
% Am. Journ. Med. Scu, 1866, p. 48. DaCosta. 



408 MATERIA MEDIC A AND THERAPEUTICS. 

and thread-worms ;* or in emulsion or capsule. Linimentum ierebinthince 
(oil of turpentine, 35 parts, melted with resin-cerate, 65 parts), is used 
as a stimulant application in various affections, as chilblain, lumbago 
and myalgia. 

Terebenum (Terebene) (C 10 H 16 ), obtained by treating oil of turpen- 
tine with H 2 S0 4 , is an oily, volatile fluid, (chiefly pinene) insoluble in 
water. It possesses antiseptic properties, and is eliminated in part 
by the lungs ; hence its value in chronic bronchitis and symptomatic 
cough. It is likewise employed by inhalation (gtt. xx) on an apkin, in 
catarrhal bronchial affections. Dose, gtt. v-x, in capsule or on sugar. 

Terpini Hydras (Terpin Hydrate) [C 10 H 18 (OH 2 )+H 2 O] is " the hy- 
drate of the diatomic alcohol terpin," which occurs in colorless rhom- 
bic prisms, almost odorless, and with a slightly aromatic, bitter taste, 
soluble in alcohol 10, and water 250 parts. 

Its effects and uses are very similar to those of oil of turpentine ; 
the dose is gr. i-iij, three to six times daily, in compressed pill or cap- 
sule. 

Pix Liquida (Tar). 

Preparation. — This is an impure turpentine, procured, by des- 
tructive distillation, from the wood of Pinus palustris and other species 
of Pinus. 

Properties and Constituents. — It is a brownish-black, viscid, 
semi-liquid substance, of a peculiar empyreumatic odor and a bitterish, 
resinous, somewhat acid taste ; soluble in alcohol, ether and the vola- 
tile and fixed oils. It consists of resin united with acetic acid, oil of 
turpentine and various volatile empyreumatic products. By distillation 
it yields pyroligneous acid and oil of tar, the residuum being pitch. 

The oil of tar (oleum picis liquidce) contains, besides oil of turpen- 
tine, creasote (see Antiseptics) and other principles. Its effects are 
similar to those of tar, and it is much used in the form of ointment in 
the treatment of squamous skin-diseases. 

The oil of cade (oleum cadini), an empyreumatic, tarry oil, derived 
from the French juniper tree, possesses similar effects to those of tar. 
It is used in chronic eczema and psoriasis, in form of soap, or diluted 
with vaseline. 

Liquor carbonis detergens, a proprietary preparation, is an alcoholic 
solution of coal-tar (pix mineralis), to which, after straining stronger 
ammonia water, glycerin and water are added. It may be used topi- 

* Journal de Thtrap., 1 8 76, p. 87 1. 



BLENNORRHE TICS— TURPENTINE. 409 

cally, in dilution or full strength, and possesses similar properties to 
those of tar. 

Aqua picis liquidae (Tar-water) (not official) is a most efficient form 
of administering tar. It is used as a spray in chronic pharyngitis, and 
laryngitis, and in nasal catarrh. 

Toxicology. — A case is reported, of non-fatal poisoning, * by oil 
of tar in a man who, having swallowed about one gill, was seized 
after seven hours with vomiting, excessive abdominal and inguinal 
pain and exhaustion, the urine being high-colored and having the odor 
of the drug. 

Effects and Uses. — Locally, tar is mildly anti-pruritic, stimu- 
lant, antiseptic and parasiticidal. It resembles the turpentines in its 
effects, and is employed in chronic catarrhal affections and other dis- 
eases of the mucous membranes. Its vapor has been inhaled in bron- 
chitis, acute and chronic (gtt. xx, hot water f5j) ; and topically it is an 
excellent application in tinea capitis, psoriasis and eczema. The thera- 
peutical application of the tarry preparations in diseases of the skin 
has been well described by Bulkley f as follows : they are contraindi- 
cated in cases of decided pain, heat or swelling, and indicated where 
it is desirable to improve the nutrition, check the itching, secretion 
and cell-deposit of a part. Their disadvantages are odor, color and 
stickiness ; the former can be partly disguised by oil of lavender. 
Equal parts of pix liquida and unguentum sulphuris is an excellent 
application to scaly eczema and palmar psoriasis, and it should be ap- 
plied with friction. In liquid form the following has been used with 
advantage to allay the intense itching of eczema after the exudation 
has ceased, and also in lichen : 3^ Picis liquidae, f 5ij ; potassae caus- 
ticae, oj ; aquae, f5v. M. — Solve (may require dilution); in chronic 
cases it should be rubbed in of full strength. The infusum picis 
liquidae (tar Oj aq. Oiv) is another serviceable liquid preparation in 
acute and chronic eczema and prickly heat, being curative as well as 
anti-pruritic ; or tar, 5^-j, in an ounce of zinc oxide ointment, may be 
used for the same purpose. In parasitic diseases, as ringworm and 
favus, the following unirritating combination is useful : ^ Iodinii, 5ij ; 
olei picis liquidae, f§j. M. — Solve. Mix carefully and rub in freely. 

Administration. — Dose, 5ss-j several times a day, in capsules. 
The syrup [syrupus picis liquidce) contains tar, water, glycerin and sugar, 



* Lancet, 1832-3, p. 598. 

I Arch, of Scientific and Practical Medicine, 1873, pp. 123, 172. 



410 MATERIA MEDICA AND THERAPELTICS. 

and is a good preparation ; dose, f5i-ij. The oil of tar [oleum picis 
liquidce) is given in TTtx doses in capsules. The oijitment [iinguentum 
picis liquidce) is made by mixing of tar 50 parts, lard 37^ parts, and 
yellow wax 12^ parts. A five per cent, soap can be obtained ; a use- 
ful form in eczema and prickly heal. Oil of cade [oleum cadini) may be 
exhibited in zinc oxide ointment as an excipient, f5j to Sj. Either the 
oils of tar or cade may be applied in collodion, f5j to foj. 

COPAIBA— BALSAM OF COPAIBA. 

Description and Habitat. — Copaiba is an oleo-resin obtained 
from several species of Copaiba (Nat. Ord. Leguminosae), large trees 
peculiar to South America. C. Langsdorffii, a native of Brazil, is now 
recognized as the principal source of copaiba, and most of the copaiba 
of commerce is derived* from the ports of Para and Maranham in 
Brazil ; Central America also yields copaiba. 

Preparation and Properties. — The juice is obtained from in- 
cisions in the stems of the trees ; as it at first exudes it is clear, color- 
less and very thin, but soon acquires a thicker consistence and a 
yellowish hue. As found in the shops it is a clear, transparent liquid, 
of the consistence of olive-oil, of a pale-yellow color, a peculiar agree- 
able smell and an acrid taste. By exposure to the air it acquires a 
deeper color and denser consistency. It is often adulterated. 

Chemical Constituents. — Copaiba is insoluble in water, but 
soluble in alcohol, ether, and the volatile and fixed oils ; with alkalies 
and alkaline earths it forms a soap. It is chemically an oleoresin (40 
to 60 per cent, of volatile oil, but the proportion of oil to resin varies 
considerably f), with a minute portion of acetic acid. The volatile 
oil is official, as is also the resin, which possesses acid properties, 
and is sometimes called copaivic acid. By exposure to the air copaiba 
gradually becomes darker and thicker, and finally hard and brittle, 
owing to the volatilization and oxidation of its oil. A pulverizable 
residue should remain when the volatile oil is driven off by heat. 
Copaiba was formerly called a balsam, but this title is incorrect, as it 
contains no benzoic or cinnamic acid. 

Contraindications. — Gastro-intestinal irritation and renal inflam- 
mation. 

Physiological Effects. — Locally it is antiseptic. The effects of 
copaiba are analogous to those of the terebinthinates. Its taste is 

* " Pharmacographia," 2d ed., p. 232. f Am. Journ. of Syphilography, ill, p. 293. 



BLENNORRHETICS— BALSAM OF COPAIBA. 411 

bitter and nauseous. Even moderate doses produce unpleasant eruc- 
tations and nausea. In large doses it proves cathartic and occasionally 
emetic. In small doses it is absorbed, communicating its peculiar 
odor to the secretions and exhalations, and stimulating the secretions 
from the mucous membranes and kidneys. The urine of persons who 
have taken copaiba for some time yields a precipitate with nitric acid, 
like albuminous urine, due to the action of the acid on the resin. The 
resinous precipitate, however, is soluble in alcohol, which does not 
dissolve coagulated albumen. Elimination takes place slowly. Occa- 
sionally copaiba causes symptoms of strangury when given in large 
doses. It sometimes produces an eruption of the skin, and some per- 
sons are unable to take it in any dose, on account of the gastrointes- 
tinal irritation which it occasions. When its administration is too 
long continued, or when excessive doses are given, it may undoubtedly 
cause serious damage to the structure of the kidney. 

Medicinal Uses. — Copaiba is employed in diseases of the mucous 
membranes, particularly those of a chronic character, as gonorrhoea, 
gleet and chronic bronchitis. 

As a remedy in gonorrhoea it has long enjoyed great popularity, 
and is given in some cases with advantage even in the early stages. 
Though often of signal service in the treatment of gonorrhoea, it fre- 
quently fails to ameliorate the disease through inattention to concomi- 
tant matters. In 15 cases in which copaiba was the basis of treatment 
together with injections, recorded by Milton,* the average duration of 
each was 88 days — not brilliant evidence of the utility of the remedy. 
During the acute stage the inflammatory symptoms, if severe, must be 
combated by rest, and the local application of lead or ice-water. The 
parts should be kept clean, the urine neutralized, a non-stimulant diet 
enforced by abstention from meats and alcoholics, and erections sup- 
pressed by avoiding lascivious thoughts. Chordee may be restrained 
by a large dose of potassium bromide (5/^-j), at 9-10 p.m., combined 
with a motor-depressant, as tincture of gelsemium (gtt. x), both to be 
repeated at 3-4 a.m., the time when chordee is most likely to set in; 
or a hypodermic of morphia can be given. When the acute symptoms 
have subsided under this plan of treatment the time for the exhibition 
of copaiba and urethral medication has arrived. Urethral injections of 
copaiba have been tried, but are ineffectual ; it therefore appears to be 
necessary, in order to obtain its curative effects, that the drug should 



*'< Gonorrhoea," etc., 1877, p. 75. 



412 MATERIA MEDICA AND THERAPEUTICS. 

be modified in the system before its passage over the urethral tract. 
In gonorrheal vulvitis and vaginitis it is comparatively useless. Co- 
paiba is sometimes advantageously combined or alternated with cubeb. 
When it nauseates, it should be suspended, or the dose reduced. It is 
best administered on an empty stomach. It is often advantageously 
combined with solution of potassa, which diminishes the acidity of, 
and hence the irritation produced by, the urine. Topically, it is used 
as a dressing to indolent ulcers. 

Administration. — Dose, gtt. xx to f5j, t. d., in emulsion, with 
some aromatic water,* or in pilular mass (massa copaibce), made by 
mixing copaiba 94 parts with magnesia 6 parts; or in capsules of gela- 
tin, which is the preferable mode of administration. These can be 
obtained in the shops, each containing Tftv or x. An elegant emulsion 
of copaiba is made as follows : ^ Copaibae, fgij ; liq. potassse, f5ij ; 
tr. opii, f5iij ; pul. acaciae, 5ss; ol. gaultheriae, f 5ss ; aq. menth. pip. 
q. s. ad f§vi. M. S. — Teaspoonful every 4 hours. 

Oleum Copaibae f (Oil of Copaiba) (C 15 H 24 ), obtained by distillation 
from copaiba, is usually colorless, with the odor and taste of copaiba, 
and produces the same effects on the system. Dose, gtt. x-xv, in 
emulsion or dropped on sugar, or in capsules. 

CUBEBA-CUBEB. 

Official Portion and Habitat. — Cubeb is the unripe fruit of 
Piper Cubeba {Nat. Ord. Piperaceae),' a climbing perennial plant of Java 
and other parts of the East Indies. 

Description. — The berries are gathered for use when unripe, and 
are dried. They are about the size of a small pea, of a blackish or 
grayish-brown color, a reticulated surface, and furnished with a stalk 
two or three lines long. The shell is hard, and contains a blackish seed, 
which is white and oily within. The odor of cubeb is aromatic. The 
berries deteriorate by age ; most rapidly in powder, owing to the escape 
of their volatile oil. They are often adulterated. 

Chemical Constituents. — Their most interesting constituents 
are a volatile oil {oleum cubebce) (chiefly C 15 H 24 ), a principle called cubebin, 
and resinous matter; the resinous matter consists of both a hard and a 

* Chapman's Copaiba Mixture is, copaiba and spirit of nitrous ether, each half a fluid- 
ounce ; powdered gum-arabic and sugar, each a drachm; compound spirit of lavender, 2 
fluidrachms ; tincture of opium, a fiuidrachm ; distilled water, 4 fluidounces ; dose, a table- 
spoonful three times a day. Often very efficient in the treatment of gonorrhoea. 

j U. S. Dispensatory, 15th ed. 



BLENNORRHE TICS— CUBEB. 413 

soft resin, the former insoluble in ether, the latter soluble in ether, of acid 
reaction, and termed cubebic acid (C 28 H 30 O 7 ). The oil is carminative and 
stimulant, and the blennorrhetic and diuretic properties of cubeb reside 
chiefly in the resin; cubebin is inert. 

Physiological Effects. — The taste of cubeb is aromatic and 
pungent. In small doses it produces a stomachic effect like that of 
black pepper. In large doses cubeb, like the other oleo-resins, excites 
more or less gastro-enteric disturbance. After its absorption it acts as 
a gentle excitant to the vascular system, with a very decided stimulant 
action on the mucous surfaces, particularly those of the urino-genital 
apparatus ; it also frequently proves diuretic. It is eliminated chiefly 
by the urine, increasing the excretion of uric acid, and under its use 
the urine yields a precipitate with nitric acid. An eruption, like urti- 
caria, occasionally follows the administration of cubeb. 

Medicinal Uses. — It is used chiefly in the treatment of gonor- 
rhoea, and should be given under the same conditions as copaiba (q. v.). 
The late Prof. Joseph Pancoast prescribed it as follows : 3^ Pulveris 

Fig. 51. 



CUBEB-BERRIES. 

aluminis, 5j ; pulveris cubebae, §iv ; pulveris cinnamomi, oss. M. et 
Sig. — Tablespoon in half a glass of water three times a day. When 
thus given, it quickly allays the scalding pain which accompanies uri- 
nation. 

Powdered cubeb-berries have been used as a smoke in nasal ca- 
tarrh ; they also enter into the composition of voice-lozenges that are 
useful in chronic pharyngitis. 

Administration. — Dose of the powder, 5j - iij, t. d., in gonorrhoea ; 
in chronic mucous disorders smaller doses are given. The oil (oleum 
cubebce) is often employed, but it does not possess the full virtues of cu- 
beb — dose, gtt. x-xij, to be repeated and gradually increased; it may 
be taken in emulsion, or dropped on sugar, or made into gelatinous 
capsules with oil of copaiba. The oleoresin (oleoresina cubebce) contains 
both the volatile oil and resin, with a portion of cubebin, and is an ex- 
cellent preparation — dose TTLv-xxx, in capsules ; of the tincture (tinc- 
tura cubebce), the dose is f5j-ij, t. d. ; of the fluid extract (extraction 
cubebce fluidwn), the dose is f5ss-j. For the relief of gonorrhoea , the 



414 MATERIA MEDICA AND THERAPEUTICS. 

fluid extract may be combined, thus : 3^ Ext. cubebae fid., f Si ; ext. 
Hydrastis fld., fgss ; elix. aromat, f §ij. M. S. — Half teaspoonful in 
water, t. d. (The elixir prevents the precipitation of the fluid extract 
of cubeb). Troches of cubed {trochisci cubebce) are made with the 
oleo-resin, oil of sassafras, extract of glycyrrhiza, and acacia, mixed 
with syrup of tolu. Each troche contains gr. T / 2 of oleoresin. 

OLEUM SANTALI-OIL OF SANTAL. 

Description and Habitat. — The oil of Santal or of Sandal 
Wood is a volatile oil distilled from the wood of Santalum album 
{Nat. Ord. Santalacese), a small tree found in tropical Asia. 

Properties. — The oil is pale yellowish and thick, readily soluble 
in alcohol when fresh, having an aromatic odor resembling the smell 
of the wood. 

Effects and Uses. — It possesses germicidal powers. The taste 
of sandal wood oil is pungent and spicy. Shortly after ingestion its 
odor is perceptible on the breath. It has been highly recommended 
in the treatment of gonorrhoea, though the experience as to its efficacy 
in this disease is contradictory. It was introduced by Henderson,* 
who states that he always obtained with it marked suppression of the 
discharge, and by whom it is regarded as quite equal to copaiba. 
Beach f reports his experience in IOO cases as follows : average dura- 
tion of the uncomplicated cases six weeks, shortest case six days, 
longest about 42 days. He gave gtt. xx or more t. d. In this disease 
its effects seem to be similar to those of copaiba, but it is not so apt 
to disagree with the stomach. In a series of 12 cases of gonorrhoea 
in which it was administered by the editor in doses of gtt. x, t. d., the 
results were not uniform. In a few cases it appeared to cut short the 
disease in about four days ; in others it disagreed with the patient and 
was abandoned, and in some cases no benefit was obtained. Milton % 
records 22 cases without a single cure. It occasionally (in about four 
per cent, of cases) produces vertigo, when the dose should be lessened 
or the medicine discontinued. It should be administered at the onset 
of the disease. 

Administration. — It may be given in doses of Tltv-xx, t. d. on a 
lump of sugar, in mucilage, or it can be obtained in gelatin capsules, 
Tflv each, in the shops. An objection to its use is the odor of the 

* Glasgow Med. Journ., Vol., XIII, p. 70; and Med. Times and Gaz., 1861, p. 571. 
•j- Boston Med. and Surg. Journ, 1868-9, p. 213. 
\ " GonorrHoea, etc.," 1887, p. 87. 



BLENNORRHE TICS—PAREIRA. 415 

drug, which its ingestion soon imparts to the breath. It is very expen- 
sive, and is often adulterated with olive oil, and oil of cedar. 

MATICO. 

Description, Habitat and Properties. — This name is given to 
the leaves of Piper angustifolium {Nat. Ord. Piperaceae), a shrub of 
Peru. They are from two to six inches long by about an inch in 
breadth, oval-lanceolate and acuminate in shape, crenate, strongly 
veined or reticulated, bright green on the upper surface, paler beneath, 
of a pleasant, aromatic odor and a strong, spicy, slightly astringent 
taste. The stalks and spikes of the plant are generally mixed with 
the leaves, more or less compressed into a lump of a greenish color. 

Chemical Constituents. — Matico contains resin, volatile oil, 
artanthic acid, tannin, etc. 

Effects and Uses. — Matico is a pleasant aromatic tonic, with a 
special determination to the mucous membranes. It is used as an 
alterative stimulant in the entire circle of diseased mucous membranes, 
especially those of the urinary passages It is also occasionally pre- 
scribed internally as a haemostatic, and topically as a styptic. 

Administration. — Dose, of the powder, 5ss-j; of the fluid extract 
{extr actum matico fluidum), f 5ss-j ; of the tincture (tinctura matico), 

f5j-ij. 

pareira. 

Description, Habitat and Properties. — Pareira or Pareira Brava 
is the root of chondodendron tomentosum {Nat. Ord. Menispermaceae), 
a native of Brazil. It comes to us in large, wrinkled, twisted or forked 
cylindrical pieces, of variable thickness and length, covered with a 
thin, grayish-brown bark. The interior is ligneous, yellowish, porous, 
inodorous, and of a sweetish, nauseous, bitter taste. The stem is 
sometimes found in the shops mixed with the root; it is inert. 

Chemical Constituents. — It imparts its virtues to water, and 
contains a bitter alkaloid, termed cissampeline (C 18 H 21 N0 3 ), (identical 
with pelosine, buxine, and beberine, Fliickiger,*) resin, fecida, etc. 

Effects and Uses. — Pareira is a remedy of some value in chronic 
cystitis and irritability of the bladder. It is also tonic, aperient, and 
diuretic. 

Administration. — Dose, in substance, 5ss-j. The fluid extract 
{e xtr actum par eirce fltddum) is much used — dose, f5ss. 

* " Pharmacographia," 2d edition, pp. 28 and 109. 



416 MATERIA MEDICA AND THERAPEUTICS. 

BUCHU. 

Description, Habitat and Properties. — This is the name given 
to the leaves of Barosma betulina and Barosma crenulata (Nat. Ord. 
Rutaceae), shrubby plants, growing at the Cape of Good Hope. As 
found in the shops, buchu leaves are from three-quarters of an inch 
to an inch and a half long, from three to five lines broad, elliptical, 
lanceolate-ovate or obovate, sometimes pointed, sometimes blunt, 
notched, and glandular at the edges, and of a green color, paler on the 
under surface. They have a strong aromatic odor and a bitterish 
taste, like that of mint. 

Chemical Constituents. — Water and alcohol extract their virtues, 
which depend on a volatile oil, which contains a liquid body of the 
composition C l0 H 18 O, having the odor of peppermint, and diosphenol 
(C 10 H 16 O 2 ), beside bitter-extractive. • 

Effects and Uses. — Buchu is a gentle stimulant to the secretions 
generally, particularly to the kidneys and urinary mucous membranes; 
it may be made to act also as a diaphoretic. It is chiefly employed in 
urethritis and chronic cystitis, chronic nephritic complaints, and inconti- 
nence of urine. 

Administration. — Dose, of the powder, gr. xx-xxx; of the fluid 
extract, f5ss-j (extraction buchu fluidum). An infusion may be had. 

uva ursi— bearberry. 

Description, Habitat and Properties. — Arctostaphylos Uva- 
ursi (Nat. Ord. Ericaceae), is a small, trailing, evergreen shrub, with 
coriaceous, obovate leaves (somewhat like the box-leaves and red 
whortleberry leaves), about half an inch in length, pale rose-colored 
flowers appearing from June to September, and small red berries 
which ripen during the winter. It is found in the northern parts of 
Asia, Europe and America. The leaves are the only part used. 
When dried they have a faint hay-like odor and a bitterish, astringent 
taste. 

Chemical Constituents. — They yield their virtues to water and 
alcohol, and contain tannic and gallic acids, ursone, a crystallizable 
glucoside termed arbutin (C 12 H 16 7 ), a bitter substance termed ericolin 
(C 34 H 56 21 ), extractive, resin, gum, etc. 

Incompatibles. — As it contains tannic acid, with the iron, lead 
and silver salts and the alkaloids. 

Effects and Uses. — Uva ursi is astringent, tonic and diuretic, and 



BLENNORRHE TICS—PIPSISSE WA. 



417 



exercises a beneficent control over discharges from mucous surfaces ; 
hence its employment in chronic cystitis and chronic bronchitis with 
profuse discharge. It is applicable also to the ordinary uses of the 
vegetable astringents. 

Administration. — Dose, of the powder, gr. x-5j. The dose of 

Fig. 52. 




UVA URSI. 



the fluid extract {extr actum uvce ursi fluiduni), is f 5ss-j ; of the extract 
(extraction uvce ursi) y gr. x-xx; of arbutin, 5i, in divided doses. 



CHIMAPHILA— PIPSISSEWA. 

Description, Habitat and Properties. — Chimaphila umbellata, 
or Ground-Holly {Nat. Ord. Ericaceae), is a small indigenous ever- 
green plant, common to the northern parts of Europe, Asia and 
America, and found abundantly in woody situations in all parts of the 
United States. It has an erect stem three to ten inches high, lanceo- 
late, somewhat wedge-shaped, serrated, dark-green leaves, arranged in 
irregular whorls, and beautiful five-petaled flowers, of a white color 
tinged with red, and a very agreeable perfume, which appear in June. 
The leaves are the official portion. In the fresh state they have a 
fragrant smell when bruised, which they lose after drying. Their taste 
is bitterish and astringent, but somewhat aromatic. 
27 



418 



MATERIA MEDIC A AND THERAPEUTICS. 

arbutin (not ursone), 



Chemical Constituents. — They contain 
tannic acid and chimaphilin (crystalline). 

Effects and Uses. — Pipsissewa is tonic, astringent, diuretic and 
blennorrhetic i resembling buchu and uva ursi in its effects, but being a 
more active diuretic, and is used in the disorders of the urinary organs 

Fig. 53. 




CHIMAPHILA UMBELLATA. 

to which they are applicable, and, from its diuretic properties, in 
dropsy. According to Abet,* who made a careful analysis of the 
leaves, the diuretic principle resides in them, which he designates as a 
"soft alcoholic extract;" and with this he got good results in ten 
cases of cardiac dropsy attended by dyspnoea. 



* Bull. Gen. de Therap., 1889, t. ii, p. 64. 



BLENNORRHE TICS— BENZOIN. 419 

Administration. — The dose of the fluid extract {exit -actum chima- 
philce fluiduni) is f5ss-j. 

MYRR.HA— MYRRH. 

Description and Habitat. — Myrrh is a gum-resin obtained 
from Commiphora Myrrha {Nat. Ord. Burseracese), a small shrubby 
tree of Arabia Felix and Africa. 

Preparation and Properties. — Most of the myrrh of commerce 
is derived from the eastern coast of Africa, in the Somali * district, 
where it is collected by the Arabs. The juice exudes spontaneously 
and concretes upon the bark (like cherry-tree gum). It is imported 
from Bombay, and occurs in small, semi-transparent, reddish-yellow 
fragments or tears — sometimes agglutinated together in large masses 
— of irregular shape and size, with an agreeable, peculiar odor and an 
aromatic taste. It is brittle and pulverizable, has a resinous fracture, 
and makes a light-yellowish powder. Inferior kinds of myrrh are 
darker and less translucent and odorous. 

Chemical Constituents. — Myrrh is a gum-resin (of resin 25-40 
per cent.), containing also a little volatile oil (^ per cent.) and a bitter- 
principle (glucoside ?). It forms with water an emulsion, and is soluble 
in alcohol and ether. 

Effects and Uses. — Locally, it is detergent and astringent. The 
taste of myrrh is peculiar, bitter and aromatic. It is stimulant, 
expectorant and emmenagogu'e . It is prescribed in chronic catarrhal 
and asthmatic affections in which a combined corroborant and 
expectorant effect is desirable. Chalybeates and aloes are frequently 
united with it in uterine affections. Topically, it is a good application 
to the spongy gums of 'gingivitis and aphthous sore mouth. In fetid 
breath and sordes the following forms a good cleansing mouth- 
wash : ^ Tincturae myrrhae, f§j ; acidi carbolici liquidi, Tftx. M. 
Sig. — Rinse the mouth with a teaspoonful in y 2 tumbler of water. 

Administration. — Dose, gr. x-xxx in powder or pill, or suspended 

in water, as in misturaferri composita (see index). The tincture (tinctura 

myrrhce) is employed chiefly externally ; dose, internally, f5ss-j. Pills 

of aloes and myrrh, are an official emmenagogue preparation of myrrh 

{see Aloes). 

benzoinum-benzoin. 

Description and Habitat. — Benzoin is a balsamic resin obtained 

from Styrax Benzoin, or Benjamin tree {Nat. Ord. Styraceae), a tall tree 

of northern Sumatra, f and Siam. 

* 'Pharm. Journal, XII, p. 226. Jas. Vaugh. 
f "History of Sumatra," p. 123, 1783. Marsden. 



420 MATERIA MEDICA AND THERAPEUTICS. 

Preparation, Varieties and Properties. — It is obtained by- 
incisions in the bark from which it readily exudes, afterward harden- 
ing by exposure to the sun and air, when it is pared off with a knife. 
Two kinds are known, the more valuable consisting chiefly of whitish 
tears, united by a reddish-brown connecting medium, and called benzbe 
amygdaloides, the other of brown or blackish lumps, without tears, 
known as benzbe in sortis {benzoin in sorts). Benzoin has a fragrant 
odor and an agreeable taste, is soluble in alcohol and ether, and is 
precipitated from its alcoholic solution by water. 

Chemical Constituents. — Its chief constituents are resin and 
benzoic acid (C 7 H 6 2 ), which places it among the balsams ; it con- 
tains volatile oil and occasionally cinnamic acid (C 9 H 8 2 ). Samples 
containing the latter should be rejected (U. S. P.). 

Effects and Uses. — The drug owes its virtues chiefly to benzoic 
acid, which will be considered under the head of Antiseptics. Benzoin 
is a mild local irritant and antiseptic. After the evaporation of an 
application of the tincture a protective-film remains. Its taste is 
aromatic. After absorption, it stimulates the broncho-pulmonary and 
other mucous membranes. It resembles myrrh in its effects, but is 
rather more acrid and stimulating. It is adapted to chronic bronchial 
affections, but is seldom employed alone. A teaspoonful of the 
compound tincture thrown into half a pint of hot water and inhaled 
through a funnel is useful in brojichial affections. As a fumigation in 
chronic laryngitis it has been recommended by Trousseau and Pidoux. 
It is also used in chronic cystitis when the urine is alkaline and deposits 
phosphates; but the benzoates, especially ammonium benzoate, are 
more adapted to these cases. R. W. Taylor uses it as a vehicle for 
corrosive sublimate, gr. ij-jv, to the fSj of the compound tincture, in 
ringworm. 

Administration. — Dose, gr. x-xxx. The tincture of benzoin 
(tinctura benzoini) ajid the compound tincture {tinctura benzoiui com- 
posed), (containing benzoin, purified aloes, storax and balsam of tolu 
dissolved in alcohol, and known as Friar's Balsam), are used as 
stimulating expectorants; dose, f5ss-ij. As benzoin has the property 
of obviating the rancidity to which lard is liable, it is a very useful 
vehicle for medicated ointments. Benzoinated lard (adeps benzoinatus) 
consists of benzoin, 2 parts, and lard 100 parts. Benzoin is much 
used in the form of fumigating pastiles. 



BLENNORRHETICS— BALSAM OF PERL. 421 

STYRAX-STORAX. 

Description and Habitat. — Storax is a balsam prepared from 
the inner bark of Liquidambar orientalis {Nat. Ord. Hamamelaceae), 
a native of Asia Minor. 

Preparation and Properties. — It is obtained by steaming the 
bruised bark and then expressing it, and occurs as a soft, viscid, 
brownish mass of the consistence of honey, yet more or less tenacious, 
of a fragrant odor and a warm taste. 

Chemical Constituents. — It contains storesin, an amorphous 
substance, — the most abundant constituent — an oil termed styrol 
(C g H 8 ) (not always present), resin, cinnamic acid (and is therefore a 
balsam), and an essential oil. Alcohol and ether are its proper sol- 
vents. It is almost always more or less adulterated. 

Effects and Uses. — It is used as a stimulant expectorant, chiefly 
in the compound tincture of bezoin. 

Administration. — Dose, gr. x-xx. Tinctura benzoini composita 
contains styrax. 

balsamum peruvianum— balsam of PERU. 

Description and Habitat. — Balsam of Peru is a balsam obtained 
from Myroxylon Pereirse (Nat. Ord. Leguminosse), a tree of Central 
America (Salvador). 

Preparation and Properties. — It is obtained from incisions in the 
bark, and is collected on rags inserted in the openings, which are 
afterward boiled in water, when the balsam settles at the bottom, and 
the water is poured off. Balsam of Peru has the consistence of honey, 
a dark, reddish-brown color, a pleasant smell, a warm, acrid taste, and 
is soluble in alcohol and partially so in boiling water. It is heavier 
than water. 

Chemical Constituents. — Its constituents are cinnamein (benzy- 
lic cinnamate, a colorless aromatic oil), resin, benzalcohol, bejtzylic ben- 
zoate, stillbene, and cmnamic and benzoic acids. 

Effects and Uses. — Locally, Balsam of Peru is sedative and 
parasiticide. Its taste is bitterish. Internally, it is a stimulating blen- 
norrhetic and tonic, employed occasionally in chronic bronchitis, asthma 
and gonorrhoea, but not much used in this country. Topically, it is 
applied mixed with acacia to pruritus vulvce ; and diluted with sulphur 
to scabies. 

Administration. — Dose, f5ss, in emulsion. 



422 MATERIA MEDICA AND THERAPEUTICS. 

BALSAMUM TOLUTANUM— BALSAM OF TOLU. 

Description and Habitat. — Balsam of Tolu is a balsam obtained 
from Toluifera Balsamum (Nat. Ord. Leguminosae), a tree of the 
neighborhood of Carthagena. 

Preparation and Properties. — It is procured from incisions in the 
trunk of the tree, and concretes in the vessels in which it is received. 
It has a soft, tenacious consistence, varying with the temperature, and 
by age becomes hard and resin-like. It is shining, translucent, of a 
reddish-brown color, a fragrant odor and a pungent taste, inflamma- 
ble, entirely soluble in alcohol and the essential oils, and, like the 
other balsams, yields its acid to boiling water. 

Chemical Constituents. — Its ingredients are resi7ts, benzylic ben- 
zoate (a colorless aromatic oil), benzylic cinnamate, tolene, and cinnamic 
and benzoic acids. 

Effects and Uses. — Locally, mild antiseptic virtues are attributed 
to it. Its taste is aromatic. It is a stimulant blemiorrhetic and tonic, 
useful in chronic catarrhal affections, and, from its agreeable flavor, 
much employed as an ingredient of cough-mixtures. The vapor of 
an ethereal solution of this balsam is inhaled with advantage for the 
relief of cough and pharyngitis. 

Administration. — Dose, gr. x-xxx, in emulsion, frequently re- 
peated. The tincture (tinctura tolutand) is added to cough mixtures; 
dose, f 5j-ij. The syrup (syrupus tolutanus) is used as a vehicle for 
other medicines. Balsam of tolu is an ingredient of the compound 
tincture of benzoin. 

MASTICHE— MASTIC 

Description and Habitat. — " A concrete resinous exudation 
from Pistacia Lenticus," {Nat. Ord. Anacardiae), a small shrub indi- 
genous to the Mediterranean. 

Properties and Constituents. — In brittle, transparent, yellowish 
globular tears the size of a pea, of a balsamic odor. It is composed 
of 90 per cent, resin (inastici)i) and volatile oil. 

Effects and Uses. — It is chewed as a masticatory to impart a 
fragrant odor to the breath, and the ethereal solution on cotton is 
inserted within carious teeth to protect the cavity ; also in pharmacy. 

Administration. — Pills of Aloes and Mastiche. See Aloes. 

The root of Anacyclus Pyrethrum (Nat. Ord. Composite), is 
chewed to excite the salivary flow. Applied to the skin it is a power- 



EMMENA GOG UES—SA VINE. 423 

ful rubefacient. It has excited violent gastric enteritis in the case of 
a child. The tincture {tinctura pyrethri) is given in the dose of Vf[ x-xx. 

The following gum-resins, previously noticed among antispas- 
modics, are employed as expectorants : — 

Asafcetida (Asafetida). (See p. 126.) 

Ammoniacum ( Ammoniac). [See p. 128.) 

ORDER VI.— EMMENAGOGUES. 

Emmenagogues (from kpLnrjvta, the catamenia, and aycoyoz, ex- 
citing) are medicines which promote the menstrual discharge, when 
deficient, absent or irregular. This discharge may be suppressed from 
various causes, and hence very opposite classes of remedies are 
employed to restore it. Thus, when amenorrhcea depends on ancemia, 
the preparations of iron are the most effectual emmenagogues ; on 
the other hand, when it occurs in connection with plethora, blood- 
letting and evacuants are resorted to. There are probably no 
articles which exert any specific influence upon the catamenia, as the 
discharge from the uterus is not one of the excretions through which 
medicinal agents pass out of the system. Medicines, however, which 
excite the pelvic circulation and stimulate the organs in the neighbor- 
hood of the uterus have a tendency to increase or excite the men- 
strual discharge. They are — 

1. The mild acrid cathartics, as Aloes, etc. 

2. Many of the stimidating diuretics, particularly Cantharides. 

3. Some of the blennorrhetics, especially Senega and Myrrh. 

4. Guaiacum, usually classed with the diaphoretics. 
Indirectly, the menstrual discharge is frequently promoted by — 

1. The preparations of Iron and of Manganese (especially Potas- 
sium Fermanganate), which are the best emmenagogues in chlorotic 
and anaemic cases. 

2. Mercurials, which prove emmenagogue from their influence 
in exciting the secretions generally. 

3. Baths: hot foot, hot hip, hot mustard ; see p. 33. 

The following articles are employed, exclusively as emmena- 
gogues :— 

sabina-savine. 

Description and Habitat. — Savine is the tops of Juniperus 
Sabina [Nat. Ord. Coniferae), a small, evergreen, bushy shrub of the 
south of Europe, which consist of dark-green, short, thin, sub- 
quadrangular branchlets, of a bitter taste. They resemble closely the 



424 MATERIA MEDIC A AND THERAPEUTICS. 

tops of Juniperus virginiana, the indigenous Red Cedar, which are 
sometimes substituted for savine in the shops. The latter has a green- 
ish color, a strong, peculiar, heavy odor, and a bitter, nauseous, resin- 
ous taste. 

Chemical Constituents. — Its virtues depend on a volatile oil 
(oleum sabince), which has a bitterish taste and a turpentine odor. It 
contains pinene (C 10 H 15 ) and cadinene, (C^H^). 

Physiological Effects. — The action of Savine depends on the 
presence of the oil. Savine is a local irritant. Taken internally, in 
medicinal doses, it stimulates the circulation and secretions, with a very 
decided secondary action on the uterus, by inducing hyperaemia of the 
pelvic organs. In large doses it will cause vomiting, purging, abdom- 
inal pain, suppressed or bloody urine, with symptoms of nervous 
depression, as shown in unconsciousness, stertorous breathing, perhaps 
convulsions, and death, usually from collapse. 

Toxicology. — Fatal * results have occurred in several cases from 
its use to provoke premature labor. Toxic amounts induce violent 
gastro-enteritis. Epsom salts and demulcents should be given in case 
of poisoning. 

Medicinal Uses. — Savine is employed internally almost exclu- 
sively as an emmenagogue in amenorrhoea, and it is considered one 
of the best medicines that can be used to stimulate the action of the 
uterine vessels, and its physiological action is intensified by combina- 
tion with oil of rue. Pereira f pronounces it " the most certain and 
powerful emmenagogue of the whole Materia Medica." Topically, it is 
used to keep up the discharge from blisters. 

Administration. — Dose, in powder, gr. v-x; but it loses much 
of its oil by drying; of the fluid extract (extr actum sabince fluiduni) 
the dose is TTLv-x. 

Oleum Sabinee (Oil of Savine) is the preparation principally used in- 
ternally. Dose, gtt. v-x — in capsules, pill or emulsion ; cautiously given. 

Oleum Rutae (Oil of Rue) (not official) is a volatile oil distilled 
from Ruta graveolens (Nat. Ord. Rutacese), a perennial European plant 
with tripinnate leaves, obovate leaflets and yellow flowers. The oil 
is a colorless or greenish-yellow liquid, of a characteristic, aromatic 
odor, a pungent, bitterish taste, and a neutral reaction. It consists 
chiefly of methyl-nojiyl-ketone (CH 3 CO.C 9 H 19 ). 

*" A Treatise on Poisons," 4th ed., p. 605. Christison. 
f -'Mat. Med. and Therap.," 4th ed. , p. 332. 



EMMENAGOGUES— TANSY. 425 

Toxicology. — Two cases of non-fatal poisoning from an unknown 
quantity of decoction of the root, in females, followed by miscarriage, 
are recorded.* 

Effects and Uses. — Its action is similar to that of oil of savine, 
but less powerful. It is prescribed in hysteria and amenorrhoea. 

Administration. — Dose, gtt. ij-v every 3 or 4 hours, in capsules. 

TANACETUM— TANSY. 

Description and Habitat. — Tansy is the leaves and tops of 
Tanacetum vulgare [Nat. Ord. Compositae), an herbaceous, perennial 
plant, indigenous to Europe but cultivated in our gardens and growing 
wild about waste places. 

Properties. — The leaves are bipinnatifid, the segments cut- 
toothed, smooth, dark-green ; the heads yellow, in a dense corymb, 
appearing in summer; the odor is strongly aromatic and the taste 
pungent and bitter. 

Chemical Constituents. — It contains an irritant volatile oil, tan- 
acetin (a bitter-principle), resin, tannin, etc. 

Physiological Effects. — When the oil is given to animals in 
small doses, it causes vomiting, dilated pupil, muscular twitchings, fol- 
lowed by clonic convulsions and a cataleptic state with death from 
paralysis of the respiratory muscles. The lungs are found engorged, 
the left side of the heart empty and the kidneys much congested. In 
man, small doses induce a sensation of heat in the epigastrium, flush- 
ing of face, giddiness and diuresis. In toxic doses it causes burning 
pain, vomiting and sometimes purging, loss of consciousness, violent 
convulsions of cerebral origin and death from respiratory paralysis. 

Toxicology. — Grave symptoms have been produced by gtt. xv of 
the oil ; but as recovery took place after 5jss had been taken the precise 
fatal dose is not known. An unknown but large quantity of tansy- 
infusion f taken by an adult negress to produce abortion, caused her 
death, the symptoms being incoherence of speech, contracted pupils, 
hebetude, and finally paralysis of the voluntary muscles, including 
those of deglutition, and lastly coma. The uterus was not affected, 
and stimulants failed to arouse her. 

Medicinal Uses. — It has been employed as a stimulating em- 
menagogue, but is an unsafe remedy. It has also been given to pro- 
duce abortion and taken with criminal intent. 

*« Woodman and Tidy," 1882, p. 358. 

f Med. Times and Gazette, April, 1861, p. 377. 



426 MATERIA MEDICA AND THERAPEUTICS. 

Administration. — Dose, of the powder, gr, x-xxx in infusion ; 
of the oil, Tflj-ij. 

CAULOPHYLLUM-BLUE COHOSH. 

Description and Habitat. — The rhizome and roots of Caulo- 
phyllus thalictroides (Nat. Ord. Berberidaceae), a plant growing from 
Canada to Kentucky with greenish-yellow flowers. 

Chemical Constituents. — Saponin, resins, and by Lloyd an 
alkaloid, caidophylline. 

Effects and Uses. — No precise action has been given to blue 
cohosh, but it is said to be sedative and emmenagogue. 

Administration. — Grains j-v, in decoction. 

inula— elecampane. 

Description and Habitat. — " The root of Inula Helenium " 
[Nat. Ord. Composite), a native of Asia, but cultivated in the United 
States. 

Chemical Constituents. — Elecampane camphor, bitter extractive, 
and a little volatile oil. 

Effects and Uses. — Nothing precise is known about its action, 
but it is given as a domestic remedy in amenorrhoea. 

Administration. — A decoction is prepared ; o% boiled in water 
Oj, dose, fSi-ij. 

The following unofficial drug enjoys a reputation as an emmena- 
gogue :— 

Apiol or Parsley Camphor (C 12 H 14 4 ) is obtained from the volatile 
oil of parsley, from the fruit of Petroselinum sativum (Nat. Ord. 
Umbelliferae). 

Properties. — It forms handsome, needle-shaped crystals, which 
melt at 30 C. A product also known as Apiol occurs as a colorless 
or yellowish oil, having a strong odor of parsley and a pungent taste, 
and is soluble in alcohol, ether and chloroform, but not in water. It 
is a mixture of several bodies, such as volatile and fixed oil, resin, etc. 

Effects and Uses. — It has been used in amenorrlioea of func- 
tional origin, especially when due to anaemia, and is believed to be a 
stimulant to the ovaries. In neuralgic dysmenorrhoea it has also been 
given with success, taken morning and evening for four or five days 
before the expected menstrual period. 

Administration. — It is prescribed in doses of gtt. ij-vj enclosed 
in gelatin-capsules. 



HjEMATINICS— PREPARATIONS OF IRON. 427 

CLASS III.— HAEMATICS. 

ORDER I.— H^EMATINICS. 

This order (from alfiariva, the red coloring matter of the blood) 
includes only the Preparations of Iron, or Chalybeates. The 
chalybeates increase the number of blood-corpuscles and the amount 
of hsematin in the blood, and are employed therapeutically in diseases 
dependent on a deficiency of these elements. They belong eminently 
to hcematics (or medicines which occasion changes in the condition of 
the blood) ; they possess also general and local tonic effects, inde- 
pendent of their action on the blood. 

FERRI PR^PARATA— PREPARATIONS OF IRON. 

The preparations of iron (Ferrum), termed Ferruginea, Chalybeates 
and Martial preparations, are the most important of the mineral tonics. 

Incompatibles. — See each preparation. 

Aids. — Arsenic, quinine, nux vomica, gentian, beef-essence, the 
red wines, and malt extract. 

Physiological Effects. — Locally: the ferrous and ferric salts 
exert no action on the skin, as they do not dissolve or attack the epi- 
dermis. Applied to a denuded surface or mucous membrane they unite 
with albumen, the ferrous salts proving astringent, the ferric coagula- 
ting the albumen ; hence their styptic and astringent action. Internally : 
the iron-salts, particularly in solution, are apt to stain the teeth a dark 
color, by the formation of a black sulphide, and they possess an astrin- 
gent taste. Taken with the food they assist the digestive process; on 
an empty stomach, or when very large doses are taken, they irritate. 
The ferric salts possess more activity than the ferrous. Absorption : 
from the stomach iron is thought to be absorbed as an albuminate. 
Metallic iron is oxidized, after ingestion, by the help of water. The 
ferrous oxide and carbonate are rendered soluble by the hydrochloric 
acid of the gastric juice. Salts of the organic acids may be absorbed 
directly into the blood, the acidulous radical being burnt off and the 
basic iron remaining to combine with the red globules. Salts of the 
mineral acids, the nitrate, chloride, and sulphate, in doses not large 
enough to constringe the tissues, are absorbed without change. Secre- 
tions : the astringent preparations of iron, as the chloride, sulphate and 
nitrate, lessen the secretions generally, especially the gastro-intestinal 
and biliary. The excretion of urea is increased. Besides their local 



428 MATERIA MEDICA AND THERAPEUTICS. 

tonic-astringent effect, and their general corroborant action on the 
cerebro-spinal system, which they possess in common with the other 
mineral tonics, they exercise a restorative influence on the composition 
of the blood, by increasing the number of its coloring particles and the 
amount of its solid constituents. Iron is in fact a natural constituent 
of the blood, and is to be considered as a nutrient rather than a 
medicine. The effects of the chalybeates are best observed in con- 
ditions of the system in which there is a relative want of the red 
corpuscles of the blood. Under their use in such cases, while the 
digestive functions are promoted, the pulse becomes fuller and stronger, 
the skin assumes a healthy tint, the lips and cheeks become more florid, 
the temperature of the body is increased, and the muscular strength is 
greatly invigorated. On the other hand, the administration of the 
ferruginous preparations in health, or too long continued, produces 
symptoms of plethora, vascular excitement, and a tendency to con- 
gestion and haemorrhage ; though it may be doubted whether the blood 
will assimilate more than the normal proportion of iron. 

The red corpuscles of the blood act as carriers of oxygen, which 
they take up from the inspired air in the lungs, and it is now believed 
that the iron in the blood-corpuscles converts oxygen into ozone, a 
more active form of this element. Iron is an essential constituent of 
haemoglobin, and observation has proven that a course of iron in anae- 
mia increases the number of red corpuscles to double or treble (Rabu- 
teau). According to Cutler and Bradford this increase does not take 
place in health. The state in which iron exists in the blood-corpuscles is 
unknown. Elimination: iron is eliminated by the bile, faeces and urine. 
The faeces are, during a course of iron, of a dark color, owing to the 
formation of ferrous sulphide. 

Medicinal Uses. — The diseases in which chalybeates are most 
serviceable are those which depend on a deficiency of the red cor- 
puscles of the blood, as various forms of ancemia, particularly where 
this is connected with irregularity of the uterine functions, as in 
chlorosis. In these conditions it is best given in rapidly-increasing 
doses pushed until it causes headache, vertigo, fever or some gastric 
disturbance, and laxatives should be occasionally administered during 
a course of iron, to unload the portal circulation and relieve the consti- 
pation which usually ensues; for the salts of iron after absorption pass 
directly through the liver, any unabsorbed portion acting as an astrin- 
gent upon the gastro-intestinal canal. After its effects are obtained 
the size of the dose can be regulated to suit the case. When anaemia 



H&MATINICS— PREPARATIONS OF IRON. 429* 

is associated with gastric disturbance, the bitter tonics and acids are 
more serviceable than iron, which, however, may be given in the form 
of bitter wine of iron, as these symptoms subside. Iron is also fre- 
quently combined with arsenic in the treatment of anaemia and 
chlorosis: 1^ Acidi arsenosi, gr. j ; ferri reducti, gr. xxx; oleoresinae 
capsici, gr. v. M. S. — Ft. pil. no. xxx; one pill t. d., increased to five 
daily if the arsenic be well borne. By some authors * the slightly 
soluble preparations (iron filings, or reduced iron) are given at first, 
followed, if well borne, by the more soluble ones. Iron in any form 
does harm in chlorosis or anaemia accompanying the early stages of 
phthisis. t In the management of anaemia and, chlorosis important ad- 
juncts will be found in rare meatSj rich broths and suitable stimulation. 
Iron is also useful in scrofula, tuberculosis, degeneration of the viscera, 
and cachectic states of the system, characterized by paleness of the lips, 
face and conjunctivae. Many forms of nervous disorders, as neuralgia, 
chorea, hysteria and epilepsy, are benefited by the preparations of iron, 
and they probably constitute the best remedies in these affections, when 
attended with anaemia. Several of the preparations of iron are also 
much employed both as stomachics and astringents. 

The following are the official preparations of iron, which are need- 
lessly multiplied in the U. S. P.: — 

Ferrum Reductum (Reduced Ir On). — PREPARATION AND PROPERTIES. 

This is obtained for medicinal purposes in the form of an impal- 
pable powder by reducing the ferric hydrate by passing a stream of 
hydrogen gas over it. It is a light, tasteless, iron-gray powder, insolu- 
ble in water, but completely soluble in diluted sulphuric acid, and it 
should be kept in a well-stoppered bottle, owing to its great liability to 
oxidation. 

Effects and Uses. — This preparation, sometimes called Que- 
venne's Iron, is a mild chalybeate, and is a favorite prescription with 
many practitioners in the treatment of chlorosis and other varieties of 
ancEmia. 

Administration. — Dose, gr. v to x, three times a day, after meals, 
in the form of pill or capsule. It is well adapted to prolonged use. 

Ferri Oxidum Hydratum (Ferric Hydrate) (Fe 2 OH 6 ). — This prepa- 
ration is made by precipitating the ferric hydrate from its combination 
in any ferric salt (officially, ferric sulphate) by means of ammonia. 

* Trousseau et Pidoux, 9th ed., Vol. I, 1880, p. 5. 
f Ibid., p. 7. 



"430 MATERIA MEDICA AND THERAPEUTICS. 

When dry, it is a reddish-brown powder, and it is not an eligible prep- 
aration for medicinal use. It is furnished in the form of a freshly- 
precipitated, soft, moist, reddish-brown magma for use as an antidote 
to arsenious acid. 

Ferri Oxidum Hydratum Cum Magnesia (Ferric Hydrate with Mag- 
nesia). — In this preparation ferric hydrate is precipitated by means of 
magnesia, instead of ammonia. It is readily prepared, and is used as an 
antidote to arsenious acid. It is to be preferred to the ordinary hy- 
drate, because the magnesia by its purgative action aids in the removal 
of any of the poison which may remain after the action of emetics or 
the use of the stomach-pump. 

Ferri Carbonas Saccharatus (Saccharated Ferrous Carbonate) is ob- 
tained by the double reaction of ferrous sulphate and sodium bicar- 
bonate, and is protected from oxidation by the addition of sugar. It is 
a greenish-gray powder, oxidizing slowly in the air, only partially sol- 
uble in water, but completely soluble in hydrochloric acid. It is a 
valuable preparation, particularly adapted to cases of weak digestion, 
as that of anorexia and astheitia, when iron is indicated. Dose, gr. 
v-xxx, in powders. 

Trochisci Ferri {Troches of Iron) are made with ferric hydrate, 
-vanilla, sugar and mucilage of tragacanth ; each lozenge contains of 
the iron gr. v. 

Emplastrum Ferri (Plaster of Iron) (strengthening plaster) is made 
with ferric hydrate, lead-plaster, Burgundy pitch, and olive-oil. 

Massa Ferri Carbonatis (Mass of Ferrous Carbonate) — Vallefs Fer- 
ruginous Mass. — To protect the ferrous carbonate (FeC0 3 ) from oxida- 
tion, it is prepared (as in the process last described) by dissolving the 
reacting salts in weak syrup instead of water ; honey and sugar being 
afterward added to preserve it unaltered and bring it to the pilular 
consistence. This preparation is one of the most popular of the chaly- 
beates. It contains nearly half its weight of ferrous carbonate. From 
gr. v-xx of the pilular mass may be taken in divided doses through 
the day. 

Pilulae Ferri Carbonatis (Pills of Ferrous Carbonate), known also 
as ferruginous carbonate, or Blaud's pills, are composed of ferrous 
sulphate, potassium carbonate, sugar, tragacanth, althaea, glycerin and 
water. They should be prepared as wanted. Dose gr. v-x. 

Mistura Ferri Composita (Compound Iron- Mixture) (Griffith's anti- 
hectic mixture) is a mixture of ferrous sulphate and potassium carbon- 
ate with myrrh, spirit of lavender, rose-water and sugar, to resist oxi- 



HyEMATINICS— PREPARATIONS OF IRON. 431 

dation. It is a favorite chalybeate in chlorosis and amenorrhcea. Dose, 
fgj to ij, t. d. 

Ferri Sulphas {Ferrous Sulphate) (FeS0 4 +7H 2 0). 

Preparation and Properties. — This salt, known in its impure 
state, as green vitriol or copperas, is prepared for medicinal use by dis- 
solving iron-wire in diluted sulphuric acid, with heat. It occurs in 
transparent, pale bluish-green crystals, of the form of oblique rhombic 
prisms, of an acrid, styptic taste, soluble in water, but insoluble in 
alcohol. By exposure to the air they effloresce, absorb oxygen, and 
become yellowish-white, from the formation of ferric sulphate. When 
heated to 239 , they give out six of their seven equivalents of water, 
and are converted into a grayish-white mass, known as the dried sul- 
phate. 

Incompatibles. — The alkalies and alkaline earths and their car- 
bonates, silver nitrate, and lead acetate, are incompatible with this salt. 

Effects and Uses. — Ferrous sulphate is one of the most active 
of the ferruginous peparations, but its local effects are powerfully 
astringent, and in a concentrated form it acts as an irritant poison. It 
is preferred to other chalybeates where there is much relaxation of 
the solids, with excessive discharges; but it is not so well adapted to 
long-continued use, on account of its local irritant action. A good 
tonic-combination useful in ancemia and dyspepsia is : ^ Ferri sulphatis 
exsiccati, gr. j ; extracti nucis vomicae, gr. y 2 ; extracti gentianae, gr. 
ij. M. S. Ft. pil. no. I ; one pill 3 or 4 times daily. 

Topically, it is employed in substance and solution as a styptic and 
astringent. Ferrous sulphate possesses moderate antiseptic powers, 
these being placed at 1 to 90 by Miquel, and it is thus used as a 
disinfectant, dissolved in water (ft)j to Oviij) to cleanse privies, drains, 
etc., under the name of copperas. 

Administration. — Dose, gr. j-v, in pill; of the dried ferrous sul- 
phate {ferri sulphas exsiccatus), gr. ss-iij. 

Ferri Sulphas Granulatus {Granidated Ferrous Sulphate). — In this 
preparation the ferrous sulphate is precipitated from an aqueous solution 
(to which H 2 SO has been added) by alcohol. Dose, gr. ss-iij, in pill. 

Liquor Ferri Tersulphatis [Solution of Ferric Tersulphate). — This 
preparation is made by dissolving ferrous sulphate in a mixture 
of sulphuric and nitric acids, with water. The nitric acid furnishes 
oxygen, which converts the iron from a ferrous to a ferric condition. 
It is a solution of the normal ferric sulphate (Fe 2 (S0 4 ) 3 ), containing 
about 28.7 per cent, of the salt. This solution is a clear, reddish- 



432 MATERIA MEDIC A AND THERAPEUTICS. 

brown liquid, nearly devoid of odor, and of a sour, very styptic, and 
somewhat acrid taste. Its chief use is in making ferric hydrate, and it 
should be kept on hand for the preparation of the antidote for arsen- 
ious acid. It may be used as a styptic, but for this purpose it is 
inferior to the next preparation. 

Liquor Ferri Subsuiphatis {Solution of Ferric Sub sulphate) (Mouse! s 
Solution) is made in the same way as the last preparation, except that 
less sulphuric acid and more ferrous sulphate are used, a basic ferric 
sulphate resulting. It has a syrupy consistence, a ruby-red color, is 
inodorous, and has a very astringent but not acrid taste. This is an 
aqueous solution of variable composition of the basic ferric sulphate, 
and is less irritant than that of the normal ferric sulphate. It may be 
used internally, in hemorrhage from the stomach and bowels, in the 
dose of from TTLv-xv, but an objection to its use is the formation of 
large coagula which are apt to excite vomiting. Topically, it is one 
of the most afficacious styptics we can employ. It has been injected 
into ncevi with success, and applied by means of the atomizer has 
been found efficient in hcemoptysis. Diluted with water, it is a good 
local application to inflamed mucous surfaces. Cotton saturated with 
Monsel's solution (styptic cotton) and dried, may be pressed firmly into 
a wound to arrest capillary oozing, and introduced within the nose to 
stop epistaxis. 

Ferri Chioridum (Ferric Chloride) ( Fe 2 Cl 6 +i2H 2 ) is made by 
heating iron-wire with hydrochloric acid (by which ferrous chloride 
is formed), and afterward converting the ferrous into ferric chloride by 
heating it with hydrochloric and nitric acids. It occurs in fragments 
of a crystalline structure, an orange-yellow color, inodorous, of a 
strong chalybeate, styptic taste, deliquescent, and wholly soluble in 
water, alcohol and ether. Internally, it is used chiefly in the form of 
the tincture. Topically, it is applied as a styptic, and in solution, 
of various strengths, as an astringent. One part, gradually added to 
six parts of collodion, forms a yellowish-red, limpid liquid, of valuable 
styptic properties, termed styptic collodion. 

Liquor Ferri Chloridi (Solution of Ferric Chloride) is prepared by 
dissolving iron-wire in hydrochloric acid, heating to the boiling point, 
then heating the liquid, after filtration, with hydrochloric and nitric 
acids, and afterward adding distilled water. A reddish-brown liquid, 
having an acid and strongly styptic taste, and sp. gr. about 1.387. It 
may be used internally for the purposes of the chloride, in doses of 
TTLij-vj, diluted, and externally as a styptic. 



HJEMA TINICS— PREPARATIONS OF IRON, 433 

Tinctura Ferri Chloridi {Tincture of Ferric Chloride). 

Preparation and Properties. — This is made by mixing 25 parts 
of solution of ferric chloride with 75 parts of alcohol. It is a tincture of 
the chloride, though there is probably some reaction between the acid 
and the alcohol, as the preparation has an ethereal odor. It is of a 
reddish-brown color, and has a sour, styptic taste. 

Incompatibles. — Tincture of ferric chloride is decomposed by the 
alkalies, alkaline earths, and their carbonates ; also by vegetable infu- 
sions containing tannin and mucilago acaciae, which throw down a 
brownish, partly transparent, jelly-like mass, and which are accord- 
ingly incompatible with it. 

Effects and Uses. — It is one of the most effective of the chaly- 
beates, acting locally as an energetic astringent and styptic, and, in 
large doses, as an irritant. Its indications, both general and topical, 
are very analogous to those of the sulphate, and it is the preparation 
of iron usually employed internally. It is especially useful in ancemia, 
erysipelas, septicemia and pyczmia, ascites, cerebral ancemia, rheumatic 
arthritis and hypochondriasis, where there is evident deficiency of red 
coloring matter in the blood. It is also often serviceable in angina 
pectoris (attack), as a tonic in emphysemz, cardiac dilatation and hemi- 
plegia. It is the remedy best suited to maintain strength and resist the 
invasion of the poison of diphtheria; to a child of 1 year, TTUj; 3 years, 
Tftv-x, every hour in syrup and water may be given. 

Administration. — Dose, TVLx to xxx, which may even be gradu- 
ally increased to f5j, in certain diseases (as erysipelas). It should be 
taken well diluted after eating, and through a glass-tube to avoid 
injury to the enamel of the teeth, or it may be mixed with equal parts 
of glycerin and taken in water, or in the form of elixir. Its strength 
and composition vary by standing ; when freshly prepared TII25 con- 
tain about gr. j of metal. Attention has been called by Prof. T. D. 
Reed* to the addition of potassium citrate in prescribing tincture of 
ferric chloride, which forms with it (probably ferric citro-chloride) a 
clear, light-green solution, possessing similar ferruginous properties, 
free from the roughness of the iron, and compatible with the astring- 
ents and bitters : ^ Tincturae ferri chloridi, f5ij ; potassii citratis, 5j ; 
syrupus limonis, f ojss ; aquae, ad f 5yj. M. S. — One tablespoonful 
represents Tftx of the iron — an elegant preparation. This combina- 
tion may be prescribed with the salicylates which are otherwise incom- 
patible with iron. 

* Canada Med. and Surg. Journ., August, 1881, p. 7. 
28 



434 MATERIA MEDICA AND THERAPEUTICS. 

Liquor Ferri et Ammonii Acetatis [Solution of Iron and Ammonium 
Acetate) (Bashanis Mixture) is made with tincture of ferric chloride, 
diluted acetic acid, solution of ammonium acetate, glycerin, elixir of 
orange and water. By the reaction of the ferric chloride and am- 
monium acetate, ferric acetate and ammonium chloride are formed. A 
most excellent preparation, and of great benefit in chronic albuminuria, 
and in dropsy generally where iron is indicated. Dose, fgss-j. It 
forms with quinine an acetate of the alkaloid. 

Ferri Iodidum Saccharatum (Saccharated Ferrous Iodide). — This 
salt is made by the addition of iron-filings to a mixture of iodine in 
distilled water, and sugar of milk is added to prevent oxidation. By 
evaporation a yellowish-white or grayish powder is obtained, of a 
sweetish, ferruginous taste, deliquescent, and very soluble in water. 
Dose, gr.x-xxx. 

Syrupus Ferri Iodidi (Syrup of Ferrous Iodide), is prepared 
by mixing iodine and iron-wire in distilled water, and shaking the 
mixture until the solution has acquired a green color, adding syrup, 
heating to 21 2°, straining, and, when the liquid has cooled, adding 
distilled water. It must be kept in well-stoppered vials. It is a 
transparent liquid, of a pale-green color, and furnishes an excellent 
alterative tonic, combining the effects of iodine and of iron, and is 
particularly applicable to the treatment of scrofula and rickets. It is 
incompatible with the alkalies, their carbonates, and tannin: with 
potssium chlorate a dangerous reaction takes place, free iodine being 
liberated. Dose, 1Uv-f5j. 

Pilulee Ferri Iodidi (Pills of Ferrous Iodide) are made with iodine, 
reduced iron, sugar, acacia, glycyrrhiza, extract of glycyrrhiza, and an 
ethereal solution of balsam of tolu. They keep very well. Each pill 
contains about gr.j of ferrous iodide and gr. ^ of reduced iron. 

Ferri et Potassii Tartras (Iron and Potassium Tartrate) is prepared 
by the addition of ferric hydrate to a mixture of potassium bitartrate 
in distilled water. It occurs in transparent scales of a ruby-red color, 
which are wholly soluble in water. The tartaric acid and potash, in 
combination in this preparation, render it less constipating than the 
other chalybeates ; and, from its agreeable taste, it is adapted to 
the diseases of childhood. It is, moreover, not incompatible with the 
alkalies. Dose, gr.x-5ss, in water and orange syrup. 

Ferri Phosphas Solubilis (Soluble Ferric Phosphate) is obtained by 
the double reaction of solutions of ferric citrate and sodium phosphate 
and evaporating to dryness. It occurs in bright-green, transparent 



HjEMATINICS— PREPARATIONS OF IRON. 435 

scales, of slightly saline taste, insoluble in alcohol, but soluble in 
water; by exposure to the light it becomes darker. According to 
Rother * it is a combination of ferric phosphate and sodic citrate. 
Dose, gr.v-x, in pill. 

Ferri Pyrophosphas Solubilis {Soluble Ferric Pyrophosphate). — It 
occurs in apple-green scales, of an acid, slightly saline taste, and is 
very soluble in water. A good chalybeate. Dose, gr.ij-v. 

Ferri Hypophosphis (Ferric Hypophosphite) [Fe 2 (PH 2 2 ) 6 ] is ob- 
tained by the reaction of a solution of sodium or ammonium hypo- 
phosphite with a solution of ferric sulphate. It is a white, amorphous 
powder, insoluble in cold water, soluble in hydrochloric acid, incom- 
patible with the soluble salts of mercury and silver, but has the advan- 
tage of not being decomposed by the cincho-tannic acid of cinchona. 
This is a good chalybeate in diseases of degeneration of the nervous 
tissue ; other hypophosphites are combined with it. Dose, gr.x-xxx, 
t. d., in pills. 

Ferri Citras {Ferric Citrate) is prepared by the addition of ferric 
hydrate to a solution of citric acid, and occurs in thin, transparent 
pieces, of a garnet-red color, with a mild, acid, chalybeate taste, slowly 
soluble in cold water, but readily soluble in boiling water. Dose, gr. 
v-x. It is official also in the form of Liquor Ferri Citratis (Solution of 
Ferric Citrate), a deep reddish-brown liquid, given in doses of gtt. 
x-xx; and it is by evaporating this solution that the solid citrate is 
obtained. 

Liquor Ferri Nitratis {Solution of Ferric Nitrate) [Fe 2 (N0 3 ) 6 ] is pre- 
pared by the gradual addition of diluted nitric acid to ferric hydrate. 
It is a pale, amber-colored liquid, with a strong, astringent, acid taste. 
It is tonic and astringent, agreeing very well with the stomach, and is 
employed in the treatment of chronic diarrhoea, hcematemesis, haemor- 
rhage from the bowels, hematuria and uterine haemorrhage, particularly 
when anaemic symptoms are present. If used against hcematemesis, the 
coagula which it forms may excite vomiting. Dose, gtt.x-xx, t. d., in 
dilution. 

Liquor Ferri Acetatis (Solution of Ferric Acetate). — Dose, Tftx-xxx. 

Ferri Lactas (Ferrous Lactate) [Fe(C 3 H 5 3 ) + 3H 2 0] is made by 
mixing diluted lactic acid with iron-filings. It occurs in greenish- 
white crystalline crusts or grains of a mild, sweetish, ferruginous taste 
sparingly soluble in water, and insoluble in alcohol. Used in chlorosis 

* Am. Jour. Pharm., 1876, p. 171, and 1883, p. 163. 



436 MATERIA MED1CA AND THERAPEUTICS. 

it has a marked effect in increasing the appetite. Dose, gr. x-xxx, in 
pill, lozenge or syrup. 

Ferri et Quininae Citras [Iron and Quinine Citrate). — This salt is 
prepared by dissolving quinine in a hot solution of iron citrate and 
evaporating the solution. As found in the shops, it is a mechanical 
mixture of ferric citrate with a variable proportion of iron and quinine 
citrate. It occurs in thin, transparent scales, of a reddish or yellowish- 
brown color, with a tint of green, slowly soluble in cold water, and of 
a ferruginous, moderately bitter taste. It combines the virtues of its 
two bases, and is thought to have an especial agency in diminishing 
the formation of urea, whence its use in urcemia. Dose, gr. v-x, in 
capsules, or water and elixir of orange. 

Ferri et Quininae Citras Solubilis [Soluble Iron and Quinine Citrate). 
Differs from the above in being readily dissolved by water. 

Vinum Ferri Amarum {Bitter Wine of Iron) is a mixture of solu- 
tion of iron and quinine citrate, tincture of sweet orange-peel, syrup 
and stronger white wine. Dose, f5j-ij. 

Ferri et Ammonii Citras [Iron and Ammonium Citrate) is made by 
adding water of ammonia to solution of ferric citrate, and evaporating. 
It occurs in the form of garnet-red translucent scales, of a slightly 
ferruginous taste, and is readily soluble in water; it has antacid prop- 
erties. Dose, v-x, in pills, capsules or solution. 

Vinum Ferri Citratis ( Wine of Ferric Citrate), a solution of ammo- 
nio-ferric citrate in tincture of sweet orange-peel, syrup and stronger 
white wine. Dose, f3j. 

Ferri et Strychnines Citras [Iron and Strychnine Citrate) is made 
by mixing a solution of strychnine and citric acid in distilled water 
with a solution of iron and ammonium citrate in water and evapora- 
ting. It occurs in garnet-red scales, of a bitter, ferruginous taste, 
readily soluble in water. An excellent tonic. Dose, gr. ij-iij, t. d., in 
pills. 

Syrupus Ferri, Quininae et Strychninae Phosphatum [Syrup of Iron, 
Quinine and Strychnine Phosphates), an agreeable tonic. Dose, foj. 

Ferri et Ammonii Sulphas [Ferric Ammonium Sulphate) [Fe 2 (NHJ 2 
(S0 4 ) 4 +24H 2 0]. — This salt, called also ammonio-ferric alum, is made by 
adding ammonium sulphate to a hot solution of ferric sulphate. It 
occurs in octahedral crystals, of a pale-violet color and sour, astrin- 
gent taste, efflorescent, and very soluble in water. Used in diarrhoea 
and chronic dysentery. Dose, gr. v-xv, two or three times a day, in 
pills or solution. 



H^EMATINICS— PREPARATIONS OF IRON. 437 

Ferri et Ammonii Tartras (Iron and Ammonium Tartrate) occurs in 
transparent, garnet-red scales, of a sweetish taste, soluble in water, in- 
soluble in alcohol and ether. A mild chalybeate. Dose, gr. x-xxx, 
in pills or solution. 

Ferri Valerianas (Ferric Valerianate), a dark, tile- red, amorphous, 
unstable powder,* of variable composition, with a mildly styptic taste 
and an odor of valerianic acid; insoluble in cold water, but readily 
soluble in alcohol. Dose, gr. j-iij, in pills.' 

Ferrum Dialysatum (Dialyzed Iron) (not official) has been intro- 
duced as a substitute for the tincture of ferric chloride, than which it is 
much less efficacious. It is not apt to constipate, is almost tasteless, 
and may be given in doses of from gtt. xv-5j thrice daily. Dialyzed 
iron is an antidote to arsenic in the stomach. To insure its conver- 
sion into ferric hydrate in the stomach, its ingestion should be followed 
by a tablespoonful of sodium chloride. 

Pills of aloes and iron and syrup of the hypophosphites with iron are 
official (see index). 

CHALYBEATE WATERS— NORTH AMERICAN. 

Schooley's Mountain Springs (Morris County, New Jersey). — An- 
alysis by C. Mclntire, Jr. One pint contains a small proportion of 
the sodium, magnesium, manganesium, calcium and iron carbonates 
with carbonic acid gas. 

Cresson Springs (Cambria County, Pennsylvania). — Analysis by 
F. A. Genth. There are three springs, viz., the Iron, Alum and 
Magnesia. The Iron contains nearly gr. y 2 of the carbonate and gr. 
iij of ferrous sulphate to the pint, besides the earthly and alkaline car- 
bonates, chlorides, etc. 

Rawley Springs (Rockingham County, Virginia). — Analysis by 
Prof. J. W. Mallet. One pint contains iron carbonate gr. \ besides 
the magnesium, calcium, and manganesium carbonates. 

New Almaden Vichy (Santa Clara County, California). — One U. 
S. gallon contains gr. 5 of iron carbonate with sodium bicarbonate gr. 
201, and chloride gr. 33, and Epsom salt gr. 12 ; also 238 cub. in. of 
free carbonic acid gas. 

The Sharon Chalybeate Spring (New York) contains iron sulphate 
gr. 24 to the U. S. gallon ; Schuyler Chalybeate Spring (New York), 
iron sulphate gr. 70 to the U. S. gallon ; Thorp's Spring (Hood County, 

Texas) iron carbonate gr. 40 to the U. S. gallon. 

- j 

* Arch, de Neurol., xix, 1890, p. 229. Valerian et ses preparations, par Yvon. 



43S MATERIA MEDIC A AND THERAPEUTICS. 



CHALYBEATE WATERS— EUROPEAN. 

Schwalbach and Pyrmont {Germany)) Spa (Belgium), and Saint 
Moritz (Switzerland). — The first-named contains almost gr. y 2 of iron 
carbonate to the pint, a large quantity of carbonic acid and a few other 
mineral ingredients ; in Pyrmont is found about gr. ^ of iron car- 
bonate to the pint, and also a large proportion of calcium sulphate and 
other salts, so that it is not a pure chalybeate water. The waters of Spa 
are almost purely chalybeate, containing gr. y^ of iron carbonate to the 
pint and much carbonic acid gas. The Saint Moritz yields about gr. \ of 
iron carbonate to the pint and it is therefore a fair ferruginous water. 

Effects and Uses. — The waters of this class, which owe their 
virtues to the presence of iron in the form of bicarbonate or sulphate 
kept in solution by carbonic acid gas, are mostly limpid and colorless. 
If the iron be present in large quantity their taste is astringent. They 
produce effects similar to the official preparations of iron, with the 
additional advantage of change of life, scene and climate, which is con- 
ferred by a sojourn at these springs. The iron waters are indicated in 
anczmia and chlorosis, and in cases generally suited to the iron prepara- 
tions. 

ORDER II.— ALTERATIVES. 

Alteratives may be defined to be medicines which produce such 
a modification of the nutritive processes as enables the vital principle 
to restore healthy action in morbid conditions of the system. The 
modus operandi of these medicines is not understood, (i) Perhaps 
their effects are owing to a correcting influence on the quality of the 
circulating fluid (thus, in inflammations they may act by diminishing 
the abnormal quantity of fibrin in the blood, rendering its red 
corpuscles less disposed to aggregation, and decreasing the number 
and adhesiveness of its white globlues); (2) perhaps their curative 
operation is of a substitutive character (by setting up an antagojiistic 
action which takes the place of diseased action jn the system); (3) or 
perhaps they may attack diseased cells, causing their disintegration 
and rapid removal from the body by means of the excretions. 

Under the influence of alteratives the secretions and exhalations 
are increased, the textures softened, and morbid growths and deposits 
are absorbed. The exudation of plastic or coagulable lymph is 
checked, and, as a consequence, also the formation of false mem- 
branes, and visceral and glandular enlargements and indurations are 
diminished and often disappear. 



AL TERA TIVES—PREPA RA TIONS OF MER CURY. 439 

If pushed too far, the alteratives soften and «ven destroy the 
textures, impoverish the blood so as to interfere with the functions of 
nutrition, and produce a condition of marasmus and cachexia. 

Their principal therapeutic employment is as antiphlogistic s or 
resolvents. The mercurials are chiefly employed in acute inflamma- 
tions and as anti-syphilitics ; the preparations of iodine in chronic 
inflammations and late syphilis. Mercurials are used in acute sthenic 
inflammations, especially in such as have a tendency to terminate in 
effusions of lymph which would seriously interfere with the function 
of the part, by forming- adhesions or false membranes. The iodic prep- 
arations are adapted to inflammations of a chronic character, and are 
particularly serviceable in indurations or enlargements of glands and 
organs, and in affections of the bones and fibrous tissues. 

Owing to the injurious results which follow the prolonged exhi- 
bition of alteratives, they are to be administered with caution, and 
their effects closely watched. 

HYDRARGYRI PR^EPARATA— PREPARATIONS OF MERCURY. 

Source and Properties. — Metallic mercury or quicksilver (Hy- 
drargyrnni) is obtained principally from the red sulphide (cinnabar). 
The chief supply of quicksilver was long derived from Spain and 
Austria, but the markets of the United States are now furnished from 
New Almaden, in California. Mercury is an odorless, tasteless, vol- 
atile, liquid metal, of a whitish color. Its atomic weight is 199.8; its 
symbol is Hg. 

Incompatibles. — The chlorides and iodine are incompatible with 
the metallic preparations of mercury ; lime-water and aromatic spirit 
of ammonia, with solutions of mercury salts. 

Aids. — Such purgatives as aloes and podophyllum enhance its 
cathartic action ; as an anti-syphilitic, potassium iodide ; sedative 
agents, as antimony, promote its depressant action. 

Contraindications. — The continued use of mercurials is contra- 
indicated in all asthenic inflammations, in renal disease or tuber- 
culosis ; or where much debility exists. Even if such be distinctly 
referable to syphilis, caution must be enjoined in their use. 

Physiological Effects. — While it retains the liquid metallic state, 
mercury is inert ; but when a preparation is taken it combines in the 
stomach and alimentary canal to form soluble and absorbable com- 
pounds — perhaps with the sodic chloride and albumen there present — 
and thus becomes active. In the blood it is said to exist as an oxy- 



440 MATERIA MEDICA AND THERAPEUTICS. 

albuminate. In the state of vapor it frequently proves injurious, in 
some instances exciting salivation, ulceration of the mouth, etc. ; in 
others inducing a peculiar affection of the nervous system termed 
slinking palsy (tremor mercurialis), which is often attended with loss of 
memory, vertigo and other evidences of cerebral disturbance, and 
sometimes terminates fatally. Workmen in quicksilver are liable to 
this affection. It is supposed by some chemists that the activity of 
mercurial emanations is owing to the oxidation of the metal before it 
is inhaled; by others, that, in the finely-divided state in which it exists 
as a vapor, it is in itself poisonous. 

All the compounds of mercury possess activity. Some of them 
are violent caustic poisons ; all of them are more or less irritant. When 
the mercurials are taken internally their effects vary with the quantity 
administered. In small and repeated doses, their influence is first 
shown in an increase of the activity of the secernents and exhalants. 
The cutaneous, mucous, biliary, salivary, urinary, and probably also 
the pancreatic secretions are all increased in amount, and at the same 
time the absorbent system becomes more active, so that the accumula- 
tion of fluids, morbid enlargements, indurations, etc., will often dis- 
appear. It is by augmentation of the secretions of the intestinal 
appendages that the mercurials prove purgative. 

Mercury increases the flow of bile. Most of the mercurial prep- 
arations probably accomplish this merely in a mechanical manner, 
i. e., by causing reflex contraction of the gall-bladder and ducts, due 
to the irritation of the mucous membrane of the duodenum ; but cor- 
rosive sublimate would seem, from the experiments of Rutherford and 
Vignal, to have considerable power as a stimulant of the hepatic 
secretory apparatus. 

When the mercurials are given in larger doses and for a period 
varying in length according to the susceptibility of the individual, 
these effects are more intense. The proportion of red corpuscles * is 
diminished. The mucous membrane of the mouth and the salivary 
glands not only take on increased secretory action, but become irritated 
and inflamed. The gums first show the mercurial influence, and are 
tender and tumefied; the whole mouth soon becomes sore ; the tongue 
is swollen ; and the saliva and buccal mucus flow abundantly, some- 
times to the extent of several pints a day. At the same time the 



* " Report of Edin. Committee on the Action of Mercury on the Biliary Secretions, 
116, 2d ed., 1874. Hughes-Bennett. 



AL PER A TIVES—PREPA RA TIONS OF MER CUR Y. 441 

breath acquires a peculiar fetidity, and the patient perceives a metallic 
taste in the mouth. The resolvent action of the mercurials is now still 
more obvious than when its impression is milder, and considerable 
emaciation usually ensues from interference with nutrition and the ab- 
sorption of fat. Formerly these effects, which are termed sialagogue 
(from the excessive flow of saliva), were commonly produced for the 
cure of disease, and, as a general rule, gradually subsided, leaving the 
health much impaired. When, however, the use of the mercurials is 
pushed too far, or it is administered to persons peculiarly susceptible 
to its action, a train of very serious symptoms ensues — as excessive 
salivation, ulceration of the mouth, sloughing of the gums, loosening 
of the teeth, and occasionally necrosis of the alveolar processes. A 
peculiar febrile condition called mercurial fever , diarrhoea, skin-dis- 
eases, neuralgia, rheumatism, disorder of the nervous system, and 
marasmus, are other symptoms which are frequently noticed after the 
abuse of mercury. 

After their absorption the mercurials (and there is no doubt that 
they are absorbed,* since they have been found in the blood, saliva, 
liver, etc.) produce several important changes in the quality of the 
blood. Exceedingly minute doses given for some time, but not too 
frequently repeated, increase the proportion of red corpuscles in this 
fluid, and the bodily weight. This has been proven by Schlesinger f 
in an elaborate series of investigations upon dogs. Immediately upon 
the establishment of salivation, the blood exhibits an increase in the 
quantity of fibrin and red corpuscles ; but at a later period it loses 
color, consistence and coagulability, and the relative proportion of 
albumen, fibrin and corpuscles is diminished. This antiplastic action 
on the blood renders the mercurials valuable as antiphlogistic reme- 
dies. They are in part eliminated by the urine, faeces and saliva. In 
the faeces they pass out as a sulphide. 

Toxicology. — A non-fatal case in which Sivss of quicksilver was 
taken to produce abortion is reported by Sir G. D. Gibb,J the chief 
symptom being trembling palsy ; there was no salivation, coloration 
on the gums or action on the uterus. The vapor of mercury when 
inhaled is poisonous. 

Antidotes. — If salivation or ulceration occur, the drug must be 
stopped and astringent gargles, as brandy and water, solutions of 

* " Mat. Med. and Therapeutics," Stille, II, i860, 782, quoted. 
f Arch. fur. exper. Path. u. Pharmak., XIII, 317. 
% The Lancet \ London, 1873, p. 339. 



442 MATERIA MEDICA AND THERAPEUTICS. 

chlorinated soda or lime, alum, etc., may be employed. In cases of 
sloughing sores, silver nitrate, or the mineral acids should be applied. 
Gastro-enteric irritation is to be treated with laxatives and opiates. 
The mercurial cachexia requires change of air, generous diet, tonics, 
etc. When the system is contaminated with mercury, it may be elimi- 
nated by the use of potassium iodide, which forms soluble compounds 
with the mercury retained in the economy. 

Medicinal Uses. — Liquid metallic mercury was formerly admin- 
istered to remove mechanical obstructions of the bowels, but its use 
has been abandoned. The preparations of mercury are employed 
therapeutically with various objects : — 

1. As indirect tonics and cholagogues — with a view to their 
action on the secretions — in dyspepsia and constipation accompanied 
with torpor of the liver, in gout, rheumatism, chronic skin-diseases, etc. 
Blue pill, mercury with chalk, and calomel, are employed with this 
view : the two former are preferred as least irritating. 

2. As antiphlogistics. — Mercury was formerly given in nearly 
all cases of acute inflammation during the stage of exudation, but 
antiseptics, antipyretics, and other measures have nowadays almost 
displaced it as an antiphlogistic remedy. 

3. As antisyphilitics. — Mercury has long been regarded as the 
only reliable remedy in secondary syphilis. So far no satisfactory expla- 
nation has been made as to its mode of action. Hughes-Bennett 
(Joe. cit.) and Wilbouchewitch * have shown that the blood of syphi- 
litics who were taking mercury underwent an increase in the number 
of red globules. It has no direct curative influence on the primary 
symptoms ; but after the ■ system has been contaminated with the 
syphilitic virus, mercury is the most certain and rapid means of des- 
troying it, — in fact is a specific remedy against syphilis. Formerly, 
wherever the chancre, with distinct induration (which is indicative of 
constitutional taint), was present, the mercurials were administered, 
but, as it is now generally conceded that the initial lesion is but a 
local manifestation of a constitutional disease, in other words, that the 
patient's system is affected with the disease, when the chancre first 
appears, and as mercury does not prevent the secondary symptoms, 
but merely modifies them in such a manner that no prognosis can be 
formed from the variety or date of appearance of the syphilides, it is 
recommended to withhold mercurials until the secondaiy lesions 

* Arch, de Physiol. Norm, et Pathol., 2d ser., I, 1874, 509. 



AL PER A TIVES—PREPARA TIONS OF MERCUR V. 443 

manifest themselves (H. Morris). Some high authorities, however, 
adhere to the rule of administering mercury from the first appearance 
of the chancre. Hutchinson's * " abortive treatment of syphilis " 
consists in the administration of gray powder (q. v.) as soon as the 
diagnosis is verified by the induration around the sore, for the purpose 
of entirely suppressing the secondary symptoms. He believes mer- 
cury is antagonistic to the microbe of syphilis. Von Zeissl'sf teaching 
is to wait eight or ten weeks after the first eruption has appeared, and 
then to give it by inunction. I do not agree with this doctrine, as it 
seems irrational to allow the disease to gain so much headway (C. 
Biddle). Ross J advises it to be given " when the base of the primary 
ulcer is thickened," as it stimulates the tissues surrounding the ulcer 
to increased action, but he offers no evidence to prove the latter state- 
ment. I am of opinion that as soon as the diagnosis of syphilis is 
positively made certain, and in this statement I am in accord with the 
view of Verneuil,§ and Hutchinson (loc. cit.), by the character of the 
ulcer, its period of incubation, the presence of a non-suppurating bubo, 
and possibly by confrontation it is time to begin a mercurial course, 
small in dose, mild in course, continued usually for a lengthy period 
(two and a half years), occasionally intermitted, the intermissions to be 
governed by its effects, and in semi-metallic form, as blue mass or gray 
powder (C. B.). In the treatment of hereditary syphilis, a mercurial 
course is indispensable. In tertiary syphilis, small doses of corrosive 
sublimate are often combined with potassium iodide with better effects 
than when the iodide is given alone ; after the tertiary symptoms have 
disappeared the mercurials should be continued for eighteen months, 
with the occasional intermission of the treatment for two or three 
weeks. Mercurials may be used not only internally, but by inunction 
and by fumigation, for Dr. Fiirbringer has shown that, although 
metallic mercury will not pass through the skin, yet when rubbed into 
the sebaceous follicles the sebaceous matter converts it into a soluble 
mercurous compound, which is then readily absorbed ; and by hypo- 
dermic injection. 

Blue pill and calomel are the antiplastics principally resorted to ; as 
antisyphilitics, both the iodides, corrosive sublimate, gray powder, blue 
pill and calomel are employed. In administering mercurials we some- 
times observe a cumulative effect ; they may be exhibited, particularly 



* Lancet, Feb., 1888, p. 372. f " Path - and. Treat, of Syphilis," 1886, p. 335. 

% The Practitioner, v, p. 220. g Bull. Gen. de Therap., Oct., 1887. 



444 MATERIA MEDICA AND THERAPEUTICS. 

to children, for some time without result, when suddenly the most 
violent symptoms of mercurial saturation will be developed. 

4. As Purgatives. — The employment of calomel and blue pill, 
as cathartics and anthelmintics, has been previously noticed (see 
index). 

5. Topically as discutients , caustics, antiseptics and antiparasitics. 
The following are the preparations of mercury which are em- 
ployed medicinally : — 

1. Metallic Mercury. — When intimately mixed with pulveru- 
lent or fatty bodies, mercury loses its liquid character — is said to be 
killed, extinguished or mortified — and acquires medicinal activity. Its 
activity is probably owing to its reduction to a state of minute division, 
which enables it to enter into combinations in the stomach. As more 
or less oxidization has always taken place in the metallic preparations 
before use, their composition is uncertain. The official preparations 
of metallic mercury are : Massa hydrargyri (mass of mercury), unguen- 
tnm hydrargyri {mercurial ointment), emplastrum hydrargyri (mercurial 
plaster), emplastrum ammoniaci cum hydrargyro (ammoniac plaster with 
mercury), hydrargyrum cum creta (mercury with chalk). 

2. Oxides. — Hydrargyri oxidunt flavum (yellow mercuric oxide), 
unguentum hydrargyri oxidi flavi (ointment of yellow mercuric oxide), 
oleatum hydrargyri (pie ate of mercury), hydrargyri oxidu7n rubrum (red 
mercuric oxide), unguentum hydrargyri oxidi rubri (ointment of red mer- 
curic oxide). 

3. CHLORiBES.—Hydraigyrichloridiim mite (mild mercurous chloride 
or calomel), hydrargyri chloridum corrosivum (corrosive mercuric chlo- 
ride, or corrosive sublimate). 

4. Iodides.— Hydrargyri iodidum flavum (yelloiv mercurous iodide), 
hydrargyri iodidum rubrum (red mercuric iodide). 

5. Hydrargyri cyanidum (mercuric cyanide). 

6. Hydrargyrum ammonia turn (ammojiiated meirtiry), unguentum 
hydrargyri ammoniati (ointment of ammoniated mercury). 

7. Hydrargyri sub sidphas flavus (yellow mercuric subsidphate). 

8. Nitrates. — Unguentum hydrargyri nitratis (ointment of mercuric 
nitrate)^ liquor hydrargyri nitratis (solution of mercuric nitrate). 

Massa Hydrargyri (Mass of Mercury). — Preparation and Prop- 
erties.— This preparation, generally known as blue mass, is made by 
rubbing mercury (33 parts), with honey of rose (34 parts), and glycerin 
(3 parts), till all the globules disappear ; then adding powdered glycyr- 



AL TERA TIVES—PREPARA TIONS OF MER CUR Y. 445 

rhiza (5 parts), and althaea (25 parts), and beating the whole into a 
mass. The trituration is now generally effected by machinery — 
usually by steam-power. It is a soft, dark-blue mass, of a convenient 
consistence for making it into pills. The mercury is in a state of 
minute division, and is chemically unaltered, though, perhaps, a very 
small portion of it is in a state of oxidation. The preparation changes 
color from being kept, becoming of an olive and even reddish tint, in 
consequence of the further oxidation of the metal. As it is often 
adulterated, it is important that it should be purchased of a reliable 
house. 

Effects and Uses. — In full doses (gr. v-xv) blue pill acts as a 
laxative, and is given for the relief of constipation and torpidity of the 
liver ; when given for this purpose it is usually followed in a few 
hours by a saline cathartic. This plan is very efficient in migraine 
and biliousness. When it moves the bowels, opium is combined with 
it. Blue mass is an efficient anti- syphilitic agent, and is often well 
combined with iron and quinine as in the following prescription : 1^ 
Massae hydrargyri, gr. %~y 2 \ ferri sulphatis exsiccati et quininae sul- 
phatis, aa gr. j ; extracti opii, gr. )/§. M. et ft. pil. j. Sig. — One pill 
half hour after meals ; it has the advantage also of being in the 
metallic state, which was the form preferred by the late Dr. Bum- 
stead. 

Toxicology. — In the case of an adult female,* gr. xviij caused 
death, the chief symptom being profuse salivation — a very excep- 
tional instance. 

Administration. — Dose, gr. v-x as a laxative ; gr. %-% t. d. 
as an anti-syphilitic ; in pill form. 

Unguentum Hydrargyri [Mercurial Ointment) (also called blue oint- 
ment). 

Preparation and Properties. — This is made by rubbing mer- 
cury with compound tincture of benzoin and mercurial ointment, then 
adding suet and lard, previously melted together, and continuing to 
rub until the globules disappear. It is an unctuous, fatty body, of a 
bluish-gray color, consisting of equal weights of fatty matter and finely 
divided mercury. A very small portion of mercurous oxide is per- 
haps present, and, as the ointment becomes darker by age, a further 
oxidation of the mercury probably takes place. 

Effects and Uses. — Mercurial ointment, when either swallowed 

* The Lancet, 1838, 215. 



446 MATERIA MEDICA AND THERAPEUTICS. 

or rubbed into the integument, slowly produces the constitutional 
effects of mercury ; locally \ it has but little irritant effect. It is scarcely 
ever used internally in the United States or Great Britain. Topically, 
it is used to mercurialize the system by friction ; to disperse non-malig- 
nant tumors; as a dressing to syphilitic sores ; and to destroy pediculi. 
For the purpose of dispelling the swelling about the joint in synovitis, 
blue ointment is much employed. When mercurial inunction is about 
to be practised in the treatment of secondary syphilis, the part to which 
the ointment is to be applied should be washed with castile-soap and 
warm water to free the skin from oily matters. Sigmund, of Vienna, 
the great advocate for this plan of treatment, recommends that the in- 
unctions (gr. xx-5ss) ? be applied to different parts of the body ; thus, 
during five successive nights this treatment should be practised on the 
legs, on the thighs, on the abdomen and sides of the chest, on the 
back, on the arms, and on the sixth night he would apply the inunc- 
tion to the legs again. The rubber should wear a glove to guard 
against the absorption of mercury. This plan of treatment is trouble- 
some and filthy, and has not been generally used, but in certain cases, 
where mercury cannot be taken internally, or does not effect a cure, 
it is of much value. During the course the patient should remain in- 
doors and keep at rest upon a sofa. Another method is to thoroughly 
rub the ointment into the soles of the feet every night for a week, 
when the inunction should be omitted for three nights, after which the 
process may be repeated. About gr. xv-xxx are required each night, 
and it is best to apply it to the feet alternately. In congenital syphilis 
the inunction may be made by smearing the mercurial ointment gr. 
v-x on the flannel roller of the infant. 

Emplastrum Hydrargyri {Mercurial Plaster) is made by rubbing 30 
parts of mercury with 12 parts of oleate of mercury till the globules 
disappear, and then adding melted lead-plaster, q. s. to make 1000 
parts. It is used as a discutient of scrofulous and syphilitic enlarge- 
ments, to enlarged joints, and is applied to the side in chronic hepatitis ; 
it may induce salivation. The plaster of ammoniac with mercury 
{emplastrum ammoniaci cum hydrargyro) is more stimulating than the 
foregoing. 

Hydrargyrum cum Creta {Mercury with Chalk) (called also gray 
powder). 

Preparation and Properties. — This is prepared by rubbing 38 
parts of mercury with 57 parts of prepared chalk and 10 parts of 
clarified honey,, with water a sufficient quantity, till all the globules 



AL TERA TIVES—PREPARA TIONS OF MERCUR Y. 447 

disappear. It is a grayish powder, containing mercury chiefly in a 
state of minute division. 

Effects and Uses. — In full doses it is a gentle laxative and 
cholagogne, milder even than blue pill ; in small doses it is an excellent 
alterative and anti-syphilitic remedy; and the chalk renders it antacid. 
It is prescribed as a cholagogue in torpid liver. In congenital syphilis 
gr. y^ may be given three times a day. Gray powder is Mr. 
J. Hutchinson's* favorite remedy in secondary syphilis, as follows : !^ 
Hydrargyri cum creta, pulveris ipecacuanhas et opii, aa gr. j. M. et 
ft. pil. i. Sig. — One every 6, 4, 3, or even 2 hours. He advises this 
preparation of mercury to be used for a long period, but always in 
small doses. 

Administration. — Dose, for adults, gr. v-xx ; for children, gr. 
ij-iij to gr. viij-x in pozvder, and not in pills, as in the latter form the 
mercury becomes squeezed out of the chalk. 

Hydrargyri Oxidum Rubrum [Red Mercuric Oxide) (HgO). 

Preparation and Properties. — It is made usually by dissolving 
mercury in diluted nitric acid, with a gentle heat, by which mercuric 
nitrate is formed ; and the nitric acid is afterward decomposed and 
driven off by calcination. The mercuric oxide, commonly called red 
precipitate, occurs in small, shining scales, of a brilliant red color, with 
a shade of orange. It has an acrid taste, and is nearly insoluble in 
water. 

Effects and Uses. — Its effects are those of a powerful irritant, 
and when taken internally, even in small doses, it excites vomiting and 
purging ; in large doses, gastro-enteritis. It is rarely or never used 
internally ; topically, it is applied as an escharotic, either in powder or 
ointment, to chancres, indolent tdcers, etc. 

Toxicology. — An instance of non-fatal poisoning f is recorded in 
the case of a female aged 15, who swallowed probably 5^, the inges- 
tion of which was only followed by some abdominal pain, mercurial 
fetor of breath, sore mouth and gums. 

Administration. — Dose, gr. xV-J^J unguentum hydrargyri oxidi 
rubri {ointment of red mercuric oxide) consists of red oxide (10 parts), 
mixed with castor oil (5 parts), and ointment (85 parts); it is a very 
useful stimulating ointment in indolent ulcers and porrigo. 

Hydrargyri Oxidum Flavum ( Yellow Mercuric Oxide). 

*"On Syphilis," 1887, p. 51. 

I Irish Hosp. Gazette, 1, 1873, p. 308. 



44S MATERIA MEDICA AND THERAPEUTICS. 

Preparation and Properties. — This is made by mixing a 
solution of corrosive sublimate with solution of soda ; potassium 
chloride is formed in solution, and mercuric oxide (HgO) is precipi- 
tated as an orange-yellow powder, which, on being heated, assumes a 
red color. The yellow oxide is without odor, of an acrid taste, is very 
slightly soluble in water, and is insoluble in cold alcohol. 

Effects and Uses. — This preparation is preferred for some pur- 
poses to the red oxide, owing to its greater purity, and especially to its 
occurring in the form of a completely amorphous powder, exhibiting no 
evidence of crystalline particles even under the microscope. This 
gives it a superiority, as a local application to the conjunctiva, in 
diseases of the eye, over the red oxide, which, from the crystalline 
character of its particles, causes more or less irritation. Unguentum 
liydrargyri oxidi flavi (ointment of yellow mercuric oxide) consists of 
yellow oxide, 10 parts, mixed with ointment, 90 parts; an efficient 
application in clearing the cornea in opacity as that of keratitis, and 
to remove the granulations of ophthalmia, and to the margin of the lid 
in blepharitis after the removal of the crusts. Oleatum liydrargyri 
(oleate of mercury) consists of yellow oxide, 20 -parts, dissolved in 
oleic acid, 80 parts, by means of heat. In the treatment of secondary 
syphilis it may be employed by inunction as a substitute for mercu- 
rial ointment. For this purpose the oleate pure should be rubbed 
on the part, or, as it is slightly irritant, it may be diluted with petrolatum 
in the same proportion, and applied with mild friction. It is a much 
cleaner preparation than mercurial ointment, and very efficacious. In 
infantile syphilis an ointment containing 5 per cent, of the oleate may be 
applied by means of roller bandages once a day. H. W. Stehvagon* 
finds the oleate inferior to blue ointment when applied locally for its 
constitutional effects, but lauds its use in ringworm of the scalp; it is 
also applied in tinea tonsurans. It is also useful to relieve pruritus. 
Yellow wash, lotio flava (a favorite application to phagedenic chancroids), 
consists of yellow mercuric oxide suspended in a weak solution of 
calcium chloride, and is made by adding corrosive sublimate 5j to lime- 
solution Oj. Black wash, lotio nigra (a favorite application to chancres, 
mucous patches, balanitis, herpes, acute eczema and prickly heat), is an 
impure mercurous oxide (Hg 2 0) in a weak solution of calcium chloride, 
and is made by adding calomel 5j to lime-solution Oj. Before use 
the bottle must be shaken. In the treatment of vesicular eczema, an 

* Am. Jour. Med. Set., Oct., 1885. 



ALTERATIVES— PREPARATIONS OF MERCURY. 449 

efficient plan is to cleanse the parts with black wash, and then to apply 
zinc oxide ointment — all to be repeated according to circumstances, or 
rags soaked in it may be laid on and allowed to evaporate. 

Hydrargyri Chloridum Mite [Mild Mercurous Chloride). 

Preparation and Properties. — This preparation (mercurous 
chloride), well known as calomel (Hg 2 Cl 2 ), is made by subliming a mix- 
ture of mercurous sulphate and sodium chloride (common salt), a double 
decomposition taking place, by which mercurous chloride and sodium 
sulphate are formed. The mercurous sulphate is previously obtained 
by boiling mercury in sulphuric acid, and afterward triturating the 
resulting mercuric sulphate with mercury. Calomel, as thus procured 
in mass, is liable to contain a little corrosive sublimate. It should be 
reduced to powder, and washed repeatedly with boiling distilled water 
until the absence of a white precipitate with ammonium hydrate shows 
that the corrosive sublimate has been removed. With a view of 
obtaining calomel in a state of very minute division, its vapor is con- 
densed in a receiving vessel filled with steam, whereby it takes the form 
of a very fine powder, and is perfectly free, from corrosive sublimate. 
The calomel thus prepared is finer and more active than can be ob- 
tained by levigation and elutriation. 

Chemistry and Tests. — Calomel, as usually manufactured by 
sublimation, is in the form of white, fibrous, crystalline cakes. It may 
be obtained in the shape of quadrangular prismatic crystals. As 
found in the shops it is a light-buff or ivory-colored powder, tasteless, 
inodorous, insoluble in water, alcohol and ether, unalterable in the 
air, but blackening by exposure to light, showing decomposition. It 
should be kept in bottles painted black or covered with black paper. 
Tests. — When pure, calomel is completely vaporizable by heat; it 
strikes a black color, free from reddish tinge, with solutions of the 
fixed alkalies ; and should not, when digested with water, form a 
white precipitate with ammonia, unless it contain corrosive sublimate. 
Calomel is insoluble in ether, corrosive sublimate moderately soluble 
in this menstruum. 

Incompatibles. — The alkalies, alkaline earths, alkaline carbon- 
ates, bromides, soaps and sulphydrates are incompatible with calomel. 
Nitrohydrochloric acid should not be prescribed with it, for fear of 
generating corrosive sublimate. Preparations containing hydrochloric 
acid and potassium, ammonium or sodium chloride, produce the same 
change. 

Physiological Effects. — Locally, it is dessicant and discutient. 
29 



450 MATERIA MEDICA AND THERAPEUTICS. 

Calomel produces the effects of the mercurials already described, causing 
bilious stools, not from direct stimulation of the liver, but probably in 
a reflex manner ; it stimulates, too, the intestinal glands, and in pur- 
gative doses proves a valuable anthelmintic. It agrees well with the 
stomach, and will often be borne when other purgatives would not be 
tolerated. It is asserted that calomel is converted into corrosive sub- 
limate in the stomach by the hydrochloric acid which it there encoun- 
ters, but there are many reasons for rejecting this hypothesis, and 
more probably it unites with the albuminous peptones there present, 
forming a compound which is soluble in the gastric fluid. 

Toxicology. — Calomel has been frequently taken in very large 
doses without any bad effects ; but instances are recorded in which, in 
excessive quantity, it has acted as an irritant poison. In the case of 
a boy* aged 14, gr. vj, and in the cases of two ladsf of 12 and 15, 
gr. xv caused death ; but such examples must be considered as very 
unusual. 

Medicinal Uses. — From the certainty and - mildness of its 
operation it is more employed to relieve constipation than any of the 
other preparations of mercury, although blue pill, which, if less certain, 
is milder, is preferred under some circumstances. As a purgative and 
cholagogue, it is prescribed in doses of gr. vj-xij in fevers, enteritis, 
yellow fever, torpidity of the liver, and many other affections ; gr. ss-j 
at bedtime, will often prove sufficiently purgative in the morning; as 
an anthelmintic, against round and thread-worms, in the same doses ; 
and in both cases it is to be followed in a few hours by a saline draught, 
castor-oil or senna. Calomel is often given in combination with other 
cathartics, as jalap, rhubarb, aloes, scammony, colocynth and gamboge. 
In the treatment of secondary syphilis it is the favorite remedy of many, 
and may- be given gr. tV, J, 3 to 4 times daily. As an antiphlogistic 
in inflammatory cases, calomel is given in doses of gr. ss-j every one, 
two, or three hours ; as an eccritic, in these doses twice or thrice a day. 
In the dose of gr. tV], frequently repeated, it is one of the best means 
of checking obstinate vomiting and na7isea ; similar doses, with sodium 
bicarbonate gr. j, may be sprinkled on the tongue every half hour, 
which will often be of great service in the gastric irritability and acute 
gastritis, following the ingestion of indigestible food, after the contents 
of the stomach have been evacuated ; and in cholera morbus. In 

* " Med. Jurisprudence," Taylor, 5th ed., p. 98. 

•j- " A Treatise on Poisons," Christison, 4th ed. , p. 428. 



ALTERATIVES— PREPARATIONS OF MERCURY. 451 

jaundice due to catarrh of the bile ducts calomel gr. tVI every 3 or 4 
hours may be given with advantage to allay irritation of the duodenal 
and biliary mucous membranes. It is sometimes added to other medi- 
cines to increase their action on the secretions, as to squill or digitalis, 
and has been lauded as a diuretic in dropsy. Cohn's* clinical investi- 
gations, however, have not led him to place much reliance on calomel as 
a diuretic in cardiac and other dropsies. As the diuretic action of the 
mercurial preparations seems to depend upon their stimulant action 
on the liver, leading to the increased formation of urea, as in the case 
of other cholagogues,f and as Rutherford has shown that calomel is 
not a true hepatic stimulant, it is probable that either some of the cor- 
rosive chloride was present in the calomel, causing diuresis, or that the 
latter was transformed into that salt in the alimentary canal.J To 
children calomel may be given in proportionally larger doses than to 
adults, and it rarely salivates them. In some cases of infantile diar- 
rhoea, very minute doses of calomel, as gr. tV, rV, 1, every hour or two, 
are highly efficacious. Topically, calomel is applied in powder, in 
opacity of the cornea ; and made into an ointment (5j to gj lard), it is 
an excellent application in a variety of cutaneous affections, as herpes 
and chronic eczema. By insufflation it is much employed in otorrhcea 
as a desiccant. It is also used in the treatment of secondary syphilis 
by fumigation. For this purpose calomel 5ss may be volatilized in a 
water-bath placed beneath a cane-bottomed chair on which the patient 
is seated, without his clothes, but wrapped to the neck in blankets 
which should envelop the chair and apparatus. The patient should 
sleep in the blanket in which he was wrapped during the fumigation. 

Administration. — The dose varies from gr. T V to gr. xij, and it 
may be dispensed in powders, granules, pills or triturates ; topically, 
5j to Sj of unguent or cold cream. 

Hydrargyri Chloridum Corrosivum {Corrosive Mercuric Chloride). 

Preparation and Properties. — This is mercuric chloride, com- 
monly called corrosive sublimate (HgCl 2 ). It is made by subliming a 
mixture of sodium chloride and mercuric sulphate (which is pre- 
viously obtained by boiling mercury with sulphuric acid) ; double 
decomposition takes place, resulting in the formation of mercuric 
chloride and sodium sulphate. Corrosive sublimate occurs in the form 

* " Ueber die diuret. Wirkung des Calomel," Inaug. Dissert., Berlin, 1887. 
f Brit. Med. Journ., Feb., 1886, pp. 377 and 433. See abstract of Report by Dr. 
Noel Paton to Scientific Grants Committee of the British Medical Association. 
% Practitioner, Sept., 1886, Spiller Locke. 



452 MATERIA MEDICA AND THERAPEUTICS. 

of white, semi-transparent, crystalline masses, permanent in the air, 
inodorous, and of an acrid, styptic taste. It is soluble in 1 6 parts of 
cold water or 14 parts of glycerin, more soluble in alcohol, and still 
more so in ether. 

Chemistry and Tests. — The aqueous solution, when exposed to 
light, is decomposed, with the precipitation of calomel and evolution 
of hydrochloric acid. The tests for detecting corrosive sublimate in 
solution are : I. A solution of potassa, soda or lime throws down a 
yellow precipitate ; 2. Potassium carbonate, a brick-red precipitate ; 3. 
Ammonia, white ammoniated mercury; 4. Potassium iodide, a bright 
scarlet-red mercuric iodide, readily soluble in excess of the precipi- 
tant ; 5. Stannous chloride, in small amount, a white precipitate of 
calomel — in excess, a dark-gray precipitate of metallic murcury; 6. 
Sulphuretted hydrogen, or sulphide in minute amount, produces a 
whitish or gray precipitate, and in large amount a black sulphide; 
7. If the solution be acidulated with hydrochloric acid and gently 
heated, bright copper-foil, when plunged into it, becomes coated with 
a silvery-white deposit of mercury ; and the metal may be afterward 
obtained by sublimation in a test-tube in the form of globules. The 
above is the method of obtaining mercury from organic mixtures, and 
it will detect about tooV<jo of a grain (Wormley*). The deposit on the 
copper-foil must be distinguished from deposits of arsenic and anti- 
mony, which are obtained in the same way. Under the microscope 
the mercury sublimate appears to be globular, the antimony amor- 
phous and the arsenic in octahedral crystals. 

Incompatibles. — It is incompatible with many of the metals, the 
alkalies and their carbonates, soap, lime-solution, tartar emetic, silver 
nitrate, the lead acetates, potassium and sodium iodides, the sulphides 
generally, syrup of sarsaparilla, and with many vegetable substances 
(as the bitters) and albuminous liquids (as milk, etc.). 

Physiological Effects. — Locally, it is antiseptic (see antiseptics), 
anti-parasitic and caustic. In medicinal doses, gr. T x — J-, corrosive 
sublimate occasions a beneficial alterative effect, without any obvious 
activity. It is a true hepatic stimulant of considerable power, increas- 
ing also the formation of urea and uric acid, and thus acting as a 
diuretic,f and likewise feebly stimulating the intestinal glands. Its 
continued use may cause salivation, but it has less tendency to produce 



*" Micro-Chemistry of Poisons," 1SS5, p. 3^ 
f Practitioner, Sept., 1886. 



AL TERA TIVES—PREPARA TIONS OF MERCUR Y. 453 

this result than any other preparation of mercury. Medicinal doses, if 
too large or too long continued, frequently produce gastro-enteric 
symptoms and the constitutional effects of mercury. Elimination is 
by the urine. 

Toxicology. — In excessive doses corrosive sublimate is a violent 
caustic poison, from its affinity for the albumen, fibrin and other con- 
stituents of the tissues. The mouth and tongue appear white 
and shrivelled. It acts very rapidly, producing the most intense 
gastro-enteritis, with violent vomiting and purging, abdominal pain 
and tenderness, bloody stools, with death from collapse, or, after 
a time, with convulsions and coma. The urine is albuminous or 
bloody, diminished in amount or suppressed. The precise fatal quan- 
tity cannot be stated, for in a number of cases the toxic amount has 
varied widely ; for instance, Taylor * reports the death of a child from 
gr. iij ; Herapath f records a fatal case from gr. xx in solution, in the 
case of a man ; while a girl { of eighteen recovered after swallowing 
about gr. xix. 

Antidotes. — The best antidote is albumen (in the form of white 
of eggs) ; or, if this is not attainable, gluten (in wheaten flour) or 
casein (in milk) may be substituted. Ferrous sulphide (if given imme- 
diately), and a mixture of iron-filings (two parts) with gold dust (one 
part), also decompose corrosive sublimate. In case of poisoning, the 
stomach must be evacuated as soon as possible, and the after-treatment 
consists in the free use of demulcents (linseed-tea, or mucilage of 
acacia), and opiates. The white of one egg will neutralize gr. iv of 
HgCl 2 . 

Medicinal Uses. — Corrosive sublimate is used chiefly as an alter- 
ative or antagonistic agent in secondary syphilis, both by the stomach 
and occasionally by hypodermic injection ; and also in cutaneous 
and rheumatic affections. In tertiary syphilis it is combined advanta- 
geously with potassium iodide, as in the following: ^ Hydrargyri 
chloridi corrosivi, gr. iss ; potassii iodidi, 5jj ; elixir aurantii, foij ; aquae 
ad f§vj. M. Sig. — f5ij, in water, t. d., after meals. It has also been 
used hypodermic ally in syphilis. For this purpose various solutions 
have been used. ^ Hydrargyri chloridi corrosivi, gr. j ; aquae destil- 
latse, fgj. M. Sig. — Inject into the muscles. Of this solution 1TLx 
contain gr. -fa. As the injection of corrosive sublimate is followed, in 

*" Medical Jurisprudence," 1865, p. 22 5- 

f The Lancet, 1845, p. 650. % Guy s Hosp. Reports, 1851, p. 212. 



454 MATERIA MEDIC A AND THERAPEUTICS. 

many instances, by inflammation and abscess, and as it seems to have 
no decided advantage over the other methods, its adoption is not 
advised [See Appendix). 

Topically, it may be used as a caustic. It is destructive to the 
lower forms of life, and hence may be used as an antiseptic in weak 
solution (i part to 2000 parts of water, or about gr. j-f5ivss, vide 
Antiseptics), instead of carbolic acid; a weak solution (gr. J^-j-ij to 
water f5j) is much employed as a wash to ulcers, an injection in gleet, 
and to remove freckles. An ointment (gr. J^-j-ij to lard §j) is a good 
application in porrigo, tiiiea, chronic eczema, phthiriasis, and skin-dis- 
eases generally of parasitic origin. There is danger from the external 
application of corrosive sublimate to a large surface. 

In gonorrhoea after the acute stage is passed, corrosive sublimate, 
gr, T2~i in water, f§viij is an excellent injection, and according to 
Koch is the most effective agent with which to kill the gonococci. 
After the first trial the strength should be regulated just short of 
irritating the urethra. It is likewise injected for the cure of gleet. 

As a tineacide in ringworm the strength may be gr. iij-v in an 
ounce of the compound tincture of benzoin, the solution to be applied 
every few days with a brush. The parts should first be cleansed with 
sapo viridis, or an alkaline lotion. The following is serviceable to 
destroy pedicidi: Ify Hydrargyri corrosivi sublimati, gr. vj ; acidi 
acetici diluti, f5ij ; aquae, ad f§iv. M. Sig. — Apply with a sponge 
morning and evening. The acid is added to dissolve the nidus of the 
lice around the base of each hair-shaft. Solutions of 1 to 1000 of 
water are used against otorrhcea, either by instillation or on cotton. 
Sattler found that in the proportion of 1 to 5000 corrosive sublimate 
prevented the multiplication of lachrymal micrococci ; and this strength, 
being tolerated readily, is in constant use in the treatment of purulent 
ophthalmia. 

Administration. — In granules from gr. ^ to T \, t. d. after meals ; 
or, if in solution, disguised by elixir of orange. For topical use see 
Antiseptics. 

Hydrargyri Iodidum Flavum ( Yellow Mercurous Iodide) (Mercurous 
Iodide) (Hg 2 I 2 ). Formerly the Green Iodide of Mercury. 

Preparation and Properties. — This is made by rubbing mer- 
cury, nitric acid, potassium iodide and distilled water together, with 
the addition of a little alcohol. It is a greenish-yellow powder, insol- 
uble in water, alcohol and ether. By exposure to the light it is par- 
tially decomposed, and becomes of a dark olive-color. 



ALTERATIVES— PREPARATIONS OF MERCURY. 455 

Effects and Uses. — This mercurial exercises a specific influence 
over the lymphatic and glandular systems, and is employed in syphilis 
and scrofula. It is a favorite with many practitioners in the treatment 
of the syphilides : ^ Hydrargyri iodidi flavi, gr. iv ; morphinae sul- 
phatis, gr. j. M. et ft. pil. xx. One of these pills may be given one- 
half hour after meals, and the dose gradually increased by one pill 
per day until tenderness of the gums, or gastro-intestinal symptoms 
supervene, when the quantity must be lessened. Mercury is benefi- 
cial in locomotor ataxia if the disease be due to recent syphilis, and the 
green iodide may be given to this end. Topically, it is applied in the 
form of ointment to syphilitic ulcers, etc. 

Administration.- — Dose, gr. %-], in granules or triturates. 

Hydrargyri Iodidum Rubrum {Red Mercuric Iodide) (Hgl 2 ). 

Preparation and Properties. — This is made by mixing solu- 
tions of potassium iodide and mercuric chloride, from which a double 
decomposition ensues, resulting in the formation of potassium chloride 
in solution, while red (mercuric) iodide is precipitated. It is a scarlet- 
red powder, which becomes yellow when heated, insoluble in water, 
but soluble in boiling alcohol and solutions of potassium iodide and 
sodium chloride. 

Effects and Uses. — It is germicidal, antiseptic, irritant and 
caustic, and is employed in the same cases as the green iodide, though 
much more energetic. In late secondary or in tertiary syphilis the fol- 
lowing prescription is often of service. 3^ Hydrargyri iodidi rubri, 
gr. iij ; potassii iodidi, 5ij ; elixir aurantii, fgiij ; aquae destillatae, q. s. 
ad §viij. M. et Sig. — Take a teaspoonful 3 times a day. 

Administration. — Dose, gr. T V, gradually increased to gr. \, in 
pill or granule ; or, still better, dissolved in a solution of potassium 
iodide. Topically, it may be used in the form of ointment (gr. xvj 
mixed with ointment Sj), and as an antiseptic agent (q. v.). 

Hydrargyri Cyanidum {Mercuric Cyanide) (Hg(CN) 2 ). 

Properties. — It is found usually in the form of permanent, pris- 
matic, white and opaque crystals, of a disagreeable styptic taste, solu- 
ble in water, less so in alcohol. 

Effects and Uses. — Mercuric cyanide is strongly germicidal and 
antiseptic. It is used as an anti-syphilitic remedy, as a substitute for 
corrosive sublimate, over which it has the advantage of not producing 
epigastric pain, and of not being decomposed by the alkalies and 
organic substances. 



456 MATERIA MEDIC A AND THERAPEUTICS. 

Toxicology. — It is an active poison, two fatal cases being re- 
ported by Christison,* one from gr. x, the other, gr. xxiijss. 

Administration. — Dose, gr. T V to J-, in granules. 

Hydrargyrum Ammoniatum {Ammoniated Mercury) (NH 2 HgCl). 

Preparation and Properties. — This preparation, commonly 
called white precipitate, is made by precipitating a solution of corrosive 
sublimate by ammonia-water; ammonium chloride is formed in solu- 
tion, and ammoniated mercury is thrown down. It is considered to 
be mercuric ammonium chloride. It is a perfectly white powder, 
insoluble in water and alcohol, decomposed by boiling water, inodor- 
ous, and has an earthy, afterward metallic, taste. It is largely adul- 
terated, chiefly with calcium sulphate. 

Incompatibles. — It cannot be mixed with iodine, bromine or 
chlorine without composition. 

Effects and Uses. — Locally, it is parasiticide and stimulant. It 
is used only as a topical application, as a powder or in the form of 
ointment to cutaneous eruptions, as phthiriasis, chronic eczema, psoria- 
sis and to destroy pedicidi and the tinea of ringworm. The official 
ointment is much too strong : gr. x-xxv to the 5 is a better pro- 
portion. 

Toxicology. — Its effects are poisonous. Grahamf reports an 
instance of non-fatal poisoning in a man who, having swallowed 5ij, 
was seized with vomiting and bloody diarrhcea, but no salivation or 
sponginess of the gums occurred. 

Administration. — Unguentum hydrargyri ammoniati, 10 parts of 
ammoniated mercury to 90 parts of benzoinated lard. 

Hydrargyri Subsulphas Flavus (Yellow Mercuric Subsidphati) 
(Hg(HgO) 2 SOJ. 

Preparation and Properties. — This salt, commonly called tur- 
peth mineral, from its resemblance to the root of Ipomcea turpethum, 
is made by throwing mercuric sulphate (as obtained from the action 
of sulphuric and nitric acids on mercury) into boiling water ; the mer- 
curic sulphate is instantly decomposed into a soluble acid salt and the 
insoluble yellow subsulphate — turpeth mineral — which is precipitated. 
It is an inodorous, lemon-yellow powder, permanent in the air, entirely 
dissipated by heat, of a rather acrid taste, and sparingly soluble in 
water. 

Effects and Uses. — It has been employed as an alterative, and 

* "A Treatise on Poisons," 4th ed., p. 427. f Brit. Med. Journ., 1S69, P- 3 2 9- 



ALTERATIVES— PREPARATIONS OF MERCURY. 457 

as an emetic in croup it is highly recommended in doses of gr. ij-v, 
repeated in fifteen minutes if there has not been decided vomiting, and 
given throughout the attack whenever the breathing becomes suffoca- 
tive from accumulations of mucus. It produces free vomiting without 
effort or subsequent depression. 

Toxicology. — In an overdose, it is poisonous,* gr. xl having 
proved fatal to a man, the chief symptoms being violent vomiting 
and purging. 

Administration. — Dose, gr. %-}i) as an emetic, gr. ij-v, in 
powder. 

Unguentum Hydrargyri Nitratis (Ointment of Mercuric Nitrate}. 

Preparation and Properties. — Mercuric Nitrate is employed 
chiefly in the form of ointment. This preparation, known as citrine 
ointment, is made by dissolving 7 parts of mercury in 10 parts of nitric 
acid and adding the solution to a mixture of nitric acid 7^ parts, with 
lard oil 76 parts, previously melted at 158 , and stirring until effer- 
vescence ceases. The chemical changes which result here are not 
precisely known ; but mercuric nitrate (2(Hg2N0 3 ).H 2 0) is probably 
formed, with fatty acids and elaidin. Citrine ointment has a fine yellow 
color and an unctuous consistence ; but if not very carefully made, it 
becomes greenish, hard and friable. 

Medicinal Uses. — It is an excellent stimulant and alterative 
application, much employed in porrigo, psoriasis, chronic eczema, 
impetigo, pruritus ani, and in a wide range of ulcerated and eruptive 
affections, rupia and acne for example. 

Administration. — It is best to dilute it, at first, with lard. 

Liquor Hydrargyri Nitratis (Solution of Mercuric Nitrate) (Mercuric 
Nitrate) (Hg(N0 3 ) 2 . 

Preparation and Properties. — This is prepared by dissolving 
red mercuric oxide (40 parts) in a mixture of nitric acid (45 parts) with 
distilled water (15 parts). It is a dense, transparent, nearly colorless 
liquid (sp. gr. 2.100), of a strongly acid taste, containing about 50 per 
cent, of mercuric nitrate in solution with some free nitric acid. 

Effects and Uses. — It is employed as a caustic application in 
hospital gangrene, lupus, venereal and malignant ulcers. 

Toxicology. — A teaspoonful of mercury f dissolved in strong 
nitric acid killed a lad aged sixteen, in two and a half hours, the 
symptoms being abdominal pain, purging and vomiting. 

*"Med. Jurisprudence," Taylor, 1865, p. 233. 
f London Med. Gazette, vii, p. 339. 



458 MATERIA MEDIC A AND THERAPEUTICS. 

AURI ET SODII CHLORIDUM— GOLD AND SODIUM CHLORIDE. 

Description and Preparation. — Gold and sodium chloride is a 
mixture of equal parts by weight of these salts dried (AuCl 3 and NaCl). 
It is an orange-colored salt, without smell but having a nauseous 
metallic taste. It is soluble in alcohol ; more so in water. 

Physiological Effects. — Locally, it is a caustic. It acts like 
the mercurials on the blood, reducing the oxidizing power of the red 
globules (Farquharson). It stimulates the glandular secretion and 
increases the secretion of urine and of perspiration. Salivation, with- 
out tendency to ulceration, sometimes succeeds its prolonged use, but 
it is less apt to occur after the use of this salt than after the other salts 
of gold.* In large doses it causes violent gastro-enteritis. It is a 
stimulant to the nervous system, especially to the spinal cord. It 
stimulates the sexual organs and is said to increase the catamenia. 
Large quantities induce symptoms analogous to those of poisoning by 
mercuric chloride. The same treatment is indicated. 

Medicinal Uses. — This salt is used chiefly as an alterative in 
chronic cases of tertiary syphilis and in scrofula. It is also recom- 
mended in nervous dyspepsia, duodenal catarrh, etc. In the chronic 
forms of Bright 's disease, granular and fibroid kidney, improvement 
sometimes follows the use of small doses of this remedy, and in 
-functional impotence it is not without value. 

Administration. — Dose, gr. ts~~tu. It is best given in granules. 

iodum— iodine. 

Source and Preparation. — Iodine (I) is an elementary, non- 
metallic substance, found in the vegetable, animal and mineral king- 
doms of nature, as in marine plants, oysters, sponges, mineral springs, 
etc. It is chiefly manufactured from the residuum of kelp (the impure 
soda obtained from the incineration of sea-weeds), in which it exists as 
a sodium iodide, by the action of sulphuric acid and manganese di- 
oxide. 

Chemistry and Tests. — It occurs in crystalline scales, of a 
bluish-black color and metallic lustre, of a strong, peculiar odor and 
an acrid taste. It is very volatile, evaporating even at common 
temperatures ; is freely soluble in glycerin, alcohol and ether, and but 
very slightly soluble in water (i part in 7000 parts of water). Its 

+ Schmidts Jahrb., June, 1870. Martin. 



AL TERA TIVES— IODINE. 459 

solubility in water is very much increased by the addition of certain 
salts, as the potassium iodide, sodium chloride, etc. When heated its 
vapor has a rich violet color, whence its name (from caidqz, violet). 
Tests. — Iodine may be detected in very minute quantity by decoction 
of starch, which produces with it a combination of a deep-blue color, 
termed " iodide of starch ; " if combined, the iodine must be first freed 
with a little nitric acid, or still better with c/tromic acid. A solution of 
iodine in chloroform should be perfectly clear. 

Incompatibles. — With the alkaloids, and most of the metallic salts, 
iodides are produced. Given in aqueous solution the iodine is precipi- 
tated ; potassium iodide promotes its solubility in water. 

Aids. — Carbolic acid and the mercurials. 

Physiological Effects. — Iodine is antiseptic, antizymotic and a 
protoplasmic poison, killing the lower forms of animal and vegetable 
life. It acts locally as an irritant ; when applied to the epidermis it 
stains it yellow, and causes itching, redness and desquamation ; and 
when inhaled in the form of vapor, it excites irritation in the air-pas- 
sages. Its taste is sharp and acrid. Internally, in medicinal doses, it 
produces a sensation of heat and burning in the stomach, and soon 
irritates that organ. It is readily absorbed by the mucous membranes 
generally, and is found in the blood chiefly in combination with 
sodium ; after absorption it produces a remedial alterative effect, with- 
out any obvious disturbance of the functions. In a physiological con- 
dition patients become thin under its use, though when iodine or the 
iodides are administered in syphilis, their alterative action on the nutri- 
tion produces embonpoint, due to the elimination of the syphilitic poison 
which has depressed nutrition, and the consequent reaction of the 
system. It excites the secretions generally, increasing the flow of urine, 
slightly relaxing the bowels, often producing a marked irritant effect 
on the respiratory mucous membrane and salivary glands, and is 
readily and rapidly eliminated from the blood, in the urine and saliva 
(See *), and by the mucous membranes generally. If administered in 
too large doses, or to persons of irritable stomach, or to individuals 
susceptible to its action, it gives rise to subacute gastro-enteritis ; and 
when continued for a long time it will produce gastro-enteric symp- 
toms — headache, giddiness and other evidence of cerebro-spinal dis- 
turbance — marasmus — sometimes discoloration of the skin — or various 
cutaneous eruptions as acne — -occasionally salivation — and frequently 

* London Med. Record, 1 873, p. 777. 



460 MATERIA MEDICA AND THERAPEUTICS. 

a wasting of the mamma and testicles. This train of symptoms is 
termed iodism. 

Toxicology and Antidotes. — In excessive doses it may act as 
an irritant poison, and has even produced death ; but such a result is 
rare. In the case of a woman * 5j in spirit foj proved fatal, the chief 
symptoms being violent pain in the throat and stomach. Culpeper f 
reports a fatal case of poisoning from the application of a preparation 
of iodine (5ij) to the entire surface of the legs of a child aged eleven. 
The symptoms were vomiting, purging (dysenteric), pain in the head 
and stomach, hiccough, and suppression of urine. Large quantities 
have, however, been taken with slight effects (Siiss). The antidote is 
starch, which may be taken in the form of flour arrow-root, or ordinary 
starch- water. The stomach should first be evacuated. The vapor of 
iodine is poisonous. 

Medicinal Uses. — Iodine has been used with success in some 
cases of vomiting of pregnancy ; a few drops of the tincture maybe 
given for this purpose. It is a most valuable resolvent remedy in chronic 
visceral and glandular enlargements, indurations, thickening of mem- 
branes, tumors, etc. It is employed in goitre and scrofula; also as an 
alterative in late secondary and tertiary syphilis when the iodides are 
not tolerated. The vapor given off by volatilizing the tincture by hot 
water in a wide-mouthed bottle has been inhaled with benefit in chronic 
bronchitis, phthisis, obstinate sneezing, and to relieve the coryza of hay- 
fever, influenza, and acute nasal catarrh. 

External Uses. — It is a valuable topical remedy, and is applied 
in the form of tincture, with the greatest advantage, to enlarged glands 
(especially when scrofulous), erysipelas, boils, carbuncles, in the forming 
stage of abscess, adenitis, and venereal bubo (with complete rest), in 
endometritis applied within the uterus upon a probe armed with cotton, 
as a counter-irritant to the chest in phthisis, chronic bronchitis, and 
pleurisy, to the skin over the larynx in acute and chronic laryngitis, 
and hoarseness (three coats), and in chronic thickenings and exudations 
aroicnd the joints, due to rheumatism, rheumatic arthritis, synovitis or 
injuries, and to promote the absorption of fluid in diseases of the bursa. 
When injected into cavities containing fluid, they should be first 
evacuated. Iodine topically is contraindicated when suppuration is 
about to take place as indicated by a hot, tense, inflamed condition of 

* Provincial Med. and Surg. Jown., 1 847, p. 356. 
| Therap. Gaz., April, 1888, p. 225. 



AL TERA TIVES— IODINE. 461 

the parts. The time then has arrived for soothing emollient applica- 
tions. As a local application, three to six coats should be applied to 
the part, morning and evening, with a camel's-hair pencil, and each 
coat allowed to become dry before the succeeding one is laid on — to 
be discontinued when desquamation occurs. Three coats are enough 
iox glandular enlargements. In some subjects these applications bring 
out papules. It is more suitable to chronic than acute affections. As 
an injection in hydrocele, it has been used with benefit. After the 
evacuation of the sac, f5ss— j is introduced, and the pain maybe dimin- 
ished by the previous injection of TTLxx or more of a solution of cocaine 
(4 per cent.). Dr. S. W. Gross * has collected 540 cases of hydrocele 
treated with iodine in which there were no deaths, recurrence in 8.15, 
and suppuration or gangrene in 1.66 per cent. In chronic pleurisy and 
empyema, after aspiration, it has been injected into the pleura to wash 
out the cavity. It is occasionally resorted to as an injection in spina 
bifida. In goitre Dr. A. Worner, of Tubingen, recommends the injec- 
tion of pure tincture of iodine after puncture and withdrawal of the 
fluid. It may also be employed with excellent effect in hypertro- 
phied tonsils and glandidar tumors. The tincture should be deeply 
injected into the part, and care must be taken not to throw the injec- 
tion into a vessel. Prof. Richet f highly recommends the hypodermic 
injection of the tincture in cases of malignant pustule. Dentists apply 
equal parts of tincture of iodine and aconite to the gums to relieve 
infla7?imation at the root of a tooth. Iodine ranks also among the best 
of the disinfectants, being available from the ease of its application as 
well as its ready portability. 

Administration. — Iodine is rarely exhibited alone, but usually in 
conjunction with potassium iodide (q. v.). To avoid gastric irritation, 
it is best given after a meal, particularly when amylaceous substances 
have been taken, as it forms with them iodized starch. Dose, gr. 
%-%, two or three times daily. Compound solution of iodine {liquor 
iodi compositus) — sometimes known as LugoVs solution (iodine 5 parts, 
potassium iodide 10 parts, distilled water 85 parts), is the usual prepa- 
ration in which iodine (free) is administered internally, dose, Tit ij-x, three 
times a day, in sweetened water and gradually increased. The tincture 
{tinctura iodi) (7 parts to alcohol 93 parts) is of a deep-brown color, 
and undergoes a gradual change when kept long ; water precipitates 



* Med. Times, April, 1888, p. 384. 

f Rev. des Set. Med., Avril 2iieme,i883. 



462 MATERIA MEDIC A AND THERAPEUTICS. 

the iodine from it, hence it is little employed internally ; dose, gtt. 
x-xx, repeated and increased. Topically, the tincture is extensively 
applied to erysipelatous and poisoned parts, chilblain and parasitic affec- 
tions, as tinea circinata, versicolor, and capitis. Stains of the tincture 
may be removed from the skin by aqua ammoniae; from linen, by 
sodium hyposulphite in solution. The compound tincture (iodine 5ss, 
potassium iodide §j, alcohol Oj is not official, but has the advantage 
over the tincture that it may be diluted with water without decomposi- 
tion, dose, gtt. xv-xxx. Iodine ointment {unguentum iodi) (made with 
iodine 4 parts, potassium iodide I part, water 2 parts, and benzoinated 
lard 93 parts) is employed as a local application in goitre, scrofulous 
tumefactions, etc., and frequently as a substitute for the tincture. Iodine 
baths have been employed, with iodine and potassium iodide dissolved 
in water, in a wooden bath-tub, in the proportion of iodine gr. iij and 
potassium iodide gr. vj to a gallon of water. By this method the sys- 
temic effects of iodine are obtained. See Appendix for hypodermic 
solution. 

POTASSIl IODIDUM -POTASSIUM IODIDE. 

Preparation and Properties. — This salt is prepared by treating 
an aqueous solution of potassa with iodine in slight excess. By this 
process a mixture of potassium iodide and potassium iodate is obtained, 
and the iodate is afterwards deoxidized and converted into iodide by 
heat and mixture with powdered charcoal. Potassium iodide (KI) 
occurs in semi-opaque, white or transparent anhydrous crystals, perma- 
nent in a dry air, rather deliquescent in a moist one, of a taste some- 
what like that of common salt. It is wholly soluble in water and 
alcohol, and its aqueous solution dissolves iodine, forming iodiiretted 
potassium iodide. It is frequently adulterated with other salts. 

Incompatibles. — With acids and acid salts, spt. nitrous ether, the 
soluble lead salts and the mercurials generally, silver nitrate and the 
alkaloids; with potassium chlorate, if a mineral acid be added, a 
poisonous potassium iodate is produced. 

Aids. — The mercurials. 

Physiological Effects. — The effects of potassium iodide are 
analogous to those of iodine, but less energetic. Locally, it acts as an 
irritant. Internally : Its taste is acrid, saline and disagreeable. When 
given by the stomach, on account of its ready diffusibility, it is soon 
taken up by the blood and can shortly be tasted in the saliva. In 
large doses it sometimes occasions nausea, vomiting, heat of stomach, 
and purging ; but it may be given in larger doses, and for a longer 



AL TERA TIVES-PO TASSIUM IODIDE. 463 

period, than iodine without causing gastro-enteric derangement. Pel- 
ikan in 1856 denied that the iodides of the alkalies irritate the gastro- 
intestinal mucous membrane, and this has recently been affirmed by 
Dr. Smirnoff (loc. cit). Under its prolonged use, the digestive func- 
tion of the gastric juice fails, although the quantity secreted remains 
unaltered (A. Smirnoff*). It stimulates the secretions, particularly 
those from mucous membranes, and very often produces coryza. 
During a course of iodide treatment acneiform eruptions are likely to 
break out. Potassium iodide decidedly lessens the secretion of milk, 
and as it disturbs the functions of the glands the relative quantity of 
the different ingredients fluctuates. Iodine appears in the milk very 
soon after the first dose of the salt is taken, and disappears as soon as 
the drug is stopped. It is found in combination with the casein 
of the milk, but the amount present bears no constant relation to the 
amount of salt administered (Dr. Max Stumpf f). Upon the vascular 
system, HuchardJ ascertained that after a dose the manometre regis- 
tered a decided fall of blood-pressure, the quantity administered being 
50 centigrams per kilo of body-weight, and the animal a rabbit. Ac- 
cording to Trasbot potassium iodide produces a vascular dilatation, 
which leads to an abundant glandular secretion. Its constitutional 
effects are powerfully alterative and resolvent, as it increases the disin- 
tegration and elimination of albuminous compounds, thus causing 
wasting and emaciation when administered in health ; but like iodine, 
it acts most readily on morbid products. It is eliminated by the 
mucous membranes generally, but chiefly by the kidneys acting as a 
diuretic and increasing the amount of water, urea, uric, phosphoric and 
sulphuric acids in the urine. 

Medicinal Uses. — It is employed in goitre and scrofula; and for the 
cure of tertiary syphilis, its action being of a specific nature, in which 
it is usually combined with some mercurial preparation; and in other 
chronic diseases, accompanied with enlargements or exudations of the 
joints. It is a most valuable anti-syphilitic remedy when the bones and 
fibrous tissues and true skin are affected, as in caries, periostitis and 
rupia. In all affections of syphilitic origin, nervous or otherwise, as 
syphilitic neuralgia, amaurosis, keratitis, or paraplegia, large doses of the 
salt give prompt relief, and in gummataoi the brain and other parts they 



*"Inaug. Dissertation," St. Petersburg, 188, 
f Deutsches Arch. f. klin. Med., Jan., 1882. 
% Bull. Gen. de Therap., 123, 1892, p. 105. 



464 MATERIA MEDICA AND THERAPEUTICS. 

are of signal advantage. It has been given hypodermically when it dis- 
orders the digestion. In chronic rheumatism, gonorrheal rheumatism 
and gout, particularly where the fibrous tissues are attacked, it is of great 
efficacy. It is highly recommended in the early stages of cirrhosis of 
the liver before contraction has taken place. As a diuretic in serous 
effusions it has been found useful. As a galactafuge, gr. xx-xxv, 
repeated twice or thrice, it is often efficacious. In spasmodic asthma, 
given between the attacks, it will often prevent their occurrence or 
increase the interval between them. As an eliminative antidote in 
mcrcurialismus and colic a pictonum its action has been already noticed. 
It has been recommended in hydrocephalus ; to promote absorption in 
the latter stage of cerebrospinal meningitis ; as an alterative in loco- 
motor ataxia, if of a specific origin ; and it has been found to exercise 
a beneficial influence in the treatment of aneurism. In deep-seated, 
aneurism, large doses (gr. xx-1) are advised by Burney Yeo * who 
thinks these exert a favorable influence by diminishing cardiac action 
and lowering the general blood-pressure. -Recently Huchard (loc.cit.) 
has called attention to the value of potassium iodide for the relief of 
the symptoms of arteriosclerosis, with abnormally high vascular ten- 
sion, atheroma, angina, and accentuated cardiac second sound. He 
begins with gr. vi-xviij, in milk daily, kept up many months, and 
intermitted with nitroglycerin. If the disease be confirmed larger 
amounts will be called for. Dr. H. W. Stelwagon f recommends it 
highly in sub-acute and chronic eczema, especially when arsenic has 
failed to exert a favorable influence on the disease, combined with 
suitable external treatment. He gives gr. ss increased to gr. v to a 
child in syrup of orange-peel and water, or to an adult, gr. v-x in 
Huxham's tincture or compound tincture of gentian. 

Administration. — Dose, gr. v-xv to 5j or more (depending on 
the idiosyncrasy of the patient), three times a day, in aqueous solution, 
disguised with the compound syrup of sarsaparilla, aromatic elixir, or 
syrup of orange, but very much larger doses may be required in ter- 
tiary syphilis. Mr. Jonathan Hutchinson % recommends beginning 
with a small dose (gr. ij-iij) at first, increased by the addition of gr. ij 
per week, if the cure be not progressing rapidly. He finds a combina- 
tion of ammonium, sodium and potassium iodides often answers 
better than the potassium salt alone, and that free ammonia or sal 

* Lancet, Feb., 1886. 

f Med. News, April 2d, 1885. % " On Syphilis," 1SS7. 



ALTERA TIVES—PO TASSIUM IODIDE. 465 

volatile increases the efficiency of any of the iodides. It maybe given 
as follows : 1^ Potasii iodidi, §i; aquae, q. s. ad f§i. M. S. — Makes a 
saturated solution ; I drop contains about gr. i of K I. For late lesions 
in congenital syphilis, Gilbert's syrup is used: 1^ Potassii iodidi, 5^ ; 
biniodide of mercury, gr. i; aquse, f§ij. M. S. — For a child of 3, 
gtt. v-x, t. d. An ointment {unguentum potassii iodidi) (potassium 
iodide, 12 parts, sodium hyposulphite 1 part, benzoinated lard J J parts, 
boiling water 10 parts) is employed for the same purpose as iodine 
ointment, and does not discolor the skin ; it is, however, of feebler 
efficacy. It is said that when administered in milk, not only is the 
unpleasant taste somewhat disguised, but the salt is less apt to dis- 
agree with the stomach. For hypodermic solution of, see Appendix. 

Ammonii Iodidum {Ammonium Iodide) (NH 4 I). 

Preparation and Properties. — This is made by the double de- 
composition of potassium iodide and ammonium sulphate in hot 
aqueo-alcoholic solution. It occurs as a white, granular, very deliques- 
cent salt, becoming yellowish-brown by exposure, but when deeply 
colored, the U. S. P. directs that " it should not be dispensed." It is 
very soluble in water and alcohol, of a taste like that of potassium 
iodide, but a little sharper. 

Medicinal Uses. — It has been similarly used as the potassium 
salt. It is useful in chronic bronchitis, capillary bronchitis, and in pneu- 
monia to promote the absorption of the exudation and to prevent 
caseous degeneration. Dose, gr. v-xv. 

Sodii Iodidum {Sodium Iodide) (Nal) may be made by the double 
decomposition of ferrous .iodide and sodium carbonate. It is a soluble, 
white, crystalline salt, used to fulfill the same indications as potassium 
iodide, than which it is said to be better borne. 

Administration. — The dose is gr. v-xv to 5i, given in the same 
way as K I. 

Strontii Iodidum {Strontium Iodide) (SrI 2 -t-6H 2 0) occurs in color- 
less hexagonal plates, odorless and of a bitter saline taste, entirely 
soluble in water. It contains 56^ per cent, of iodine. Its effects and 
uses are similar to K I, and it is said to be less irritating and depress- 
ing. Dose the same. 

Medicinal Uses. — Iodine is employed in medicine in various 
chemical combinations. The iron, lead and mercurial iodides have 
been noticed. Zinc iodide (see p. 201) is employed as a tonic and 
astringent. Sulphur iodide {sulphuris iodidum) is prepared by heating 
together iodine 4 parts, and washed sulphur, 1 part; it is a grayish- 
30 



466 MATERIA MEDICA AND THERAPEUTICS. 

black solid substance, of a radiated crystalline appearance, having the 
smell and taste of iodine, decomposed upon exposure to the air and 
by boiling water and alcohol, insoluble in water, but soluble in 60 
parts of glycerin ; it is used internally in scrofulous and cutaneous 
affections, in doses of gr. %—], and topically in tinea capitis, lupus, lepra, 
acne, etc., in the form of ointment (gr. xxx to lard §j). 

Sympus Acidi Hydriodici {Syrup of Hydriodic Acid) is a syrupy 
liquid containing about 10 per cent, by weight of hydriodic acid (HI). 
Its effects and uses are similar to those of the iodides and iodine ; dose, 
f5i-j, diluted. 

OLEUM MORRHILE-COD-LIVER OIL. .. 

Description and Source. — This is a fixed oil obtained from the 
liver of Gadus Morrhua, the common cod {Class Pisces; Ord. Tele- 
ostia, Fam. Gadida) — a well known fish of the northern Atlantic — and 
also from the livers of several other species of Gadus. 

Preparation and Varieties. — It is prepared by subjecting the 
livers to heat, either in boilers with water or by means of steam ex- 
ternally applied, and afterward draining off the liquid portion, from 
which the oil separates on standing. It is said to be sometimes pro- 
cured also by expression. Three varieties are known, the white or 
pale-yellow, the brownish-yellow, and the dark-brozvn. They differ 
chiefly in the mode of preparation — the pale being prepared from fresh 
livers, the dark brown from those which are collected at sea and have 
undergone putrefactive decomposition, and the brownish-yellow from 
those in which putrefaction has only partially commenced. The pale 
oil is the purest ; the dark oil is the most offensive to the taste and 
smell, and the least acceptable to the stomach. 

Chemical Constituents. — Cod-liver oil is of the consistence of 
lamp-oil, and has a peculiar odor, resembling that of shoe leather — 
which is usually prepared in the United States with this oil — and a 
fishy-acrid taste. These sensible properties are probably the best tests 
of the oil, and it should be rejected if the smell and taste of shoe- 
leather are wanting, or if those of lamp-oil or fish-oil are very per- 
ceptible. The sp. gr. of the best oil is about 0.920-0.925. The oil 
undergoes a gradual change from exposure to the air, and should, 
therefore, be kept in full and well-stoppered bottles. It is insoluble in 
glycerin and water, somewhat so in alcohol, readily soluble in ether 
and chloroform. It contains a great variety of chemical constituents, 
the most important of which are fatty acids, several biliary principles, 
a peculiar brown substance called gaduin (which is not, however, sup- 



ALTERATIVES— COD-LIVER OIL. 467 

posed to be the active ingredient), iodine, chlorine, and traces of bro- 
mine. 

Dr. Joseph Lefage,* assisted by Dr. Chapoteaut, obtained a pro- 
duct from the oil which they named morrhuol, and which represents 
the active principles of cod-liver oil. Morrhuol is acrid, bitter, very 
aromatic and partly crystalline at ordinary temperatures. It contains 
considerable quantities of iodine, bromine and phosphorus. The oil 
after its removal is tasteless and odorless. 

Tests. — Cod-liver oil may be distinguished from other oils by the 
agency of sulphuric acid, a drop of which, when added to fresh cod- 
liver oil, on a porcelain plate, causes a centrifugal movement in the 
oil, and gives rise to a fine violet color, soon passing into yellowish or 
brownish-red. This reaction is attributable, however, to the bile con- 
tained in the oil. By reaction with ammonia, in distillation, the pe- 
culiar volatile principle trimethylamine (the odorous principle of pickled 
herring) is developed. 

Physiological Effects. — The taste of cod-liver oil is fishy and 
disagreeable. Like all fats, it is appropriated not in the stomach, but 
in the small intestine where it is emulsified by the pancreatic juice and 
bile forming the molecular base of the chyle. Being colloidal and 
therefore not in a state to osmose easily, its passage through the 
intestinal walls into the portal blood is facilitated by the bile. Its pro- 
longed use, in doses which allow it to be retained by the digestive 
tube, produce very marked beneficial effects in a wide range of chronic 
diseases dependent on a vitiated condition of the functions of digestion, 
assimilation and nutrition. Its modus medendi is not well understood, 
some therapeutists believing it to act merely as a nutritive agent, 
valuable from the readiness with which it is assimilated ; others attri- 
buting its curative powers to an alterative action from the iodine and 
bromine or other principles which it contains. Its effects are, how- 
ever, probably due merely to its nutrient action, in supplying a suffi- 
ciency of molecular base for interstitial growth. The biliary principles 
which it contains promote its absorption and appropriation by the 
system. The most striking feature of its action on the economy is 
increase of weight; and usually, where it fails to increase the weight, 
it is of little service. It is believed, also, to diminish the formation of 
uric acid in the system, and hence may be useful in gout. In large 

* Der Fortschritt, Feb. 20th, 1 886, from Le Bull, de Therap., and Le Bull. Com. 



468 MATERIA MEDICA AND THERAPEUTICS. 

doses, cod-liver oil produces nausea and diarrhoea, and these effects 
occasionally follow the use of medicinal doses. 

Medicinal Uses. — Cod-liver oil has long been known as a remedy 
in rheumatic diseases ; and within the last forty years it has come into 
extensive use as an alterative and nutrient in tuberculous and scrofulous 
affections, and in various cachexia as rickets. In the treatment of 
phthisis pulmonalis it is now looked upon, in Great Britain and the 
United States, as equal to or superior to any 'other agent, and as pos- 
sessing an undoubted power of arresting the progress of both the 
general and the local symptoms of the disease. Although efficacious 
in all the stages of phthisis, its value is most conspicuous early in 
the disease, especially before the formation of true tubercles. 

Over the different forms of scrofula it exercises also a very de- 
cided control — particularly adenitis, ulcers, affections of the joints, rickets, 
ophthalmia and keratitis. In the various cutaneous affections, tertiary 
syphilis, chronic rheumatism, rheumatic arthritis, and gout, and the 
entire circle of chronic disorders in which there is a tendency to mar- 
asmus, and where the nutrition is defective, as in hemiplegia, emphy- 
sema, and asthenia, cod-liver oil is employed with benefit. Its good 
effects are most conspicuous in proportion to the youth of the 
patient. 

Administration. — Dose f5ss two or three times a day, one hour 
after each meal ; though, if unacceptable to the stomach, it is best to 
begin with f 5j doses. The addition of a little ether (gtt. xij-xx to f 5j 
of oil) promotes its digestion. It must be persevered with for a long 
time before its good effects appear. It may be given in emulsion : Jfy 
01. ricini, fgviij ; pul. acaciae, §ij ; ol. amygdalae amarse, gtt. viij ; 
aquae, q. s. Oi. M. S. Ft. emulsio ; contains 50 per cent, of oil. Capsules 
of cod-liver oil, Tft 45 to f 5ij may be had ; and it is often combined 
with extract of malt. The union of the oil with lime-water, just 
enough to form a soap, often renders it acceptable to delicate stomachs, 
and it may be flavored with oil of bitter almond. If it produce 
diarrhoea, astringents should be administered with it, or the dose 
should be decreased, or the oil stopped. It is used as a clyster in 
cases of ascarides and lumbricoides ; and topically, as a lubricant in 
cutaneous affections, and in opacity of the cornea. 

Phosphorated cod-liver oil is made by the direct addition of 
phosphorated oil (see p. 179) to the amount of cod-liver oil required 
to furnish the desired strength of phosphorus. 



ALTERATIVES— PREPARATIONS OF ARSENIC. 469 

ARSENII PRiEPARATA— PREPARATIONS OF ARSENIC. 

Metallic arsenic is inert, though when swallowed it may prove 
powerfully poisonous by becoming oxidized and converted into 
arsenous acid. It is not used in medicine. 

Acidum Arsenosum {Arsenous Acid) (As 2 3 ), sometimes called 
white arsenic, arsenic oxide or arsenic. 

Preparation, Source and Properties. — It is obtained principally 
as a secondary product in the roasting of cobalt ores (the cobalt arsen- 
ides) in Saxony and Bohemia. It is afterward purified by sublimation, 
and when recently prepared, occurs in glassy, colorless, transparent 
masses of a vitreous fracture, which gradually become white and 
opaque, progressively from the surface inward. It is kept sometimes 
in the shops in the form of a fine white powder ; but in this state it is 
liable to adulteration with chalk or calcium sulphate, and it should, 
therefore, be always purchased in masses. It is entirely volatilized by 
heat, at a temperature not exceeding 424.4 F. ; has no smell and 
little or no taste ; is soluble in water, and also in alcohol and oils. 
Cold water dissolves from T oV oth to -^th part of its weight of arsenous 
acid, or about gr. ss-j to f5j. By prolonged boiling with water ^th 
part will be dissolved and retained in solution, or about gr. xij to f§j.* 

Tests. — Owing to the frequent use of arsenous acid as a poison, 
a knowledge of the means of detecting its presence is of great impor- 
tance. In the solid state it may be recognized in the first place by its 
volatility (heated over a spirit-lamp, it passes off as a white, inodorous 
vapor, and is deposited on a cool surface as an amorphous powder or 
in octahedral crystals) : secondly, when thrown on burning charcoal 
it is deoxidized, and gives out the garlicky odor of metallic arsenic 
(other substances give off a similar odor) ; and thirdly, if heated in a 
glass-tube with charcoal or black flux, it sublimes and condenses in 
the form of a brilliant steel-gray ring or mirror, soluble in sodium or 
calcium hypochlorite. In aqueous solution arsenous acid may be 
detected by the following reagents : sulphuretted hydrogen or ammonium 
sulphide produces a lemon or sulphur-yellow arsenic trisulphide, which 
may be distinguished from the antimonial and stannic sulphides by 
being soluble in a solution of ammonium carbonate and insoluble in 
diluted hydrochloric acid; the addition first of ammonia and then of 



* " Med. Jurisprudence and Toxicology," 1884, p. 239, Reese; also Taylor's " Med. 
Jurisprudence," 7th Am. ed., p. 140. 



470 MATERIA MEDICA AND THERAPEUTICS. 

silver nitrate produces a canary-yellow silver arsenite ; and the addition 
of ammonia and then of cupric sulphate produces an apple or grass-green 
cupric arsenite; gr. ioo boiled with diluted hydrochloric acid, and 
then treated with sulphuretted hydrogen, yield a deposit of arsenic tri- 
sulphide weighing gr. 124. The arsenic trisulphide may be reduced and 
made to yield metallic arsenic, if heated with soda flux or potash flux. 

A very delicate test for arsenous acid in solution is that of nascent 
hydrogen termed Marsh's test. When the acid is submitted to the 
action of nascent hydrogen (evolved by the action of diluted sulphuric 
acid on pure zinc), it is deoxidized, and unites with the hydrogen to 
form arseniuretted hydrogen gas. This gas has a garlicky odor, and 
is recognized by its burning with a bluish-white flame which deposits 
on a plate of cold glass or porcelain, held over the jet, a lustrous steel- 
gray or brownish black spot or mirror of metallic arsenic, surrounded 
by a faint white ring of arsenous acid ; the metallic spot deposited is 
distinguishable from antimony, obtained by a similar process, by the 
addition of a drop or two of fuming nitric acid, with heat, which 
dissolves both metals, the solutions yielding on evaporation white 
residues, but the arsenical residue, touched with a drop of strong 
solution of silver nitrate, assumes a brick-red color, while the anti- 
monial residue remains unchanged ; and also the arsenic can be 
dissolved by a solution of sodium or calcium hypochlorite, which does 
not affect antimony. 

Another test is that of Reinsch, which consists in boiling a solu- 
tion of the acid with hydrochloric acid and copper-foil or wire, when 
the latter acquires a steel-gray coating of metallic arsenic, passing, as 
it increases, into black. Other metals, as mercury and antimony, are 
deposited on copper under similar treatment, so that additional tests 
will have to be made to prove their absence. 

The Berzelius- Marsh test consists in the decomposition of arseniu- 
retted hydrogen gas in the reduction tube (of a Marsh-apparatus) by 
heat, with the production of a metallic deposit before the flame is 
reached. It is now considered to be the most delicate of all the tests. 
When arsenous acid is dissolved with liquid organic substances, it 
should first be separated from insoluble matters by filtration, and the 
metallic arsenic may be ihen obtained by Reinsclis process, and the 
liquid or subliming tests afterward applied. If the poison be mixed 
with solid organic substances, they should be cut up and boiled with 
water acidulated with hydrochloric acid, and the solution afterward 
filtered and again boiled, etc. 



ALTERATIVES— PREPARATIONS OF ARSENIC. 471 

Incompatibles. — With the salts of silver, copper, ammonia, lime- 
water, iron and the vegetable astringents. 

Aids. — Quinine, iron, nux vomica. 

Physiological Effects. — Arsenous acid acts locally as an escha- 
rotic by destroying the vitality of the parts to which it is applied. It 
exerts a feeble, slow destructive action on spores, and has weak anti- 
putrefactive powers. In medicinal doses it stimulates the digestive 
and nutritive functions, as is shown by the well-known results of 
arsenic-eating among the peasantry of Austria. Ringer and Murrell's* 
experiments upon frogs show that arsenic is poisonous to all nitro- 
genous tissues, but that it takes some time for it to destroy the con- 
ductivity of the motor-nerves and the muscular irritability. Their 
experiments differ from those of Sklarek f in respect to sensation and 
reflex action, for they found that the afferent nerves retained their 
conductive power, while Sklarek states that sensation and reflex action 
are abolished in ten minutes. The paralysis finally produced by 
arsenic is centric, with which statement all observers agree. 

The physiological effects of arsenic are not, at first, very obvious. 
It is almost tasteless. When continued for some time, it usually pro- 
duces more or less heat and dryness of the throat and stomach, with 
nausea, increased secretion from the bowels and kidneys, irritation of 
the conjunctival and nasal mucous membranes, and a peculiar swelling 
of the face termed oedema arsenicalis ; after the latter symptom appears, 
the medicine should be suspended. No matter how administered, or 
by what channel it enters the system, arsenic shows a marked selective 
affinity for the gastro-intestinal and mucous tracts. The absorption % 
of arsenous acid into the system, after its administration, is shown 
by its presence in the blood, viscera, bile, urine, sweat, the buccal, 
bronchial and intestinal mucous membranes, and after the ingestion of 
large doses, a considerable amount is found in the liver (Lolliot)§. 
According to Rabuteau,|| arsenic diminishes the excretion of urea, but 
other observers have not confirmed this statement. 

Recently arsenic has been found to be deposited in the nervous 
system : thus, if in fresh muscle I part is found, the proportion in 



* Journ. of Physiol., 1878-9, p. 213. 

f Arch, fur Anat. ti. Physiol., 1866, p. 481. 

\ Arch. Gen. de Med., t. IV, 6ieme ser., p. 173 ; Bergeon et Lemaitre. 

§ Bull. Gen de Therap., LXXV, p. 358. 

|| Gaz. Hebdom., V, p. 705. 



472 MATERIA MEDICA AND THERAPEUTICS. 

liver is 10.8; in brain, 36.5; in the spinal cord, 37.3 (Scolosubofif*). 
Injected into the blood in mammals it causes an enormous sinking of 
the blood-pressure with slowing of the pulse rate (Unterbergerf). 

Small doses of arsenic increase the cardiac action and the activity 
of the capillary circulation ; large doses cause palpitation, a small, quick 
and irregular pulse, with flushed face and cokl extremities ; poisonous 
doses depress the circulation and (in the lower animals) paralyze the 
heart in diastole. Arsenic, if too long continued or given in an exces- 
sive dose, decreases the number of red globules in the blood, decomposes 
the haemoglobin and renders it less coagulable (Brodie, quoted by 
Phillips). Small doses stimulate, while larger doses depress, both the 
respiratory centre and the pulmonary end-organs of the pneumogastric. 
At first the urine is increased, but if the drug be continued it is dimin- 
ished, and may be bloody or albuminous (Kossel J). In too long-con- 
tinued or too large medicinal doses, arsenous acid sometimes produces 
a kind of chronic poisoning, characterized by disorders of the digestive 
apparatus, conjunctivitis, oedema of the face, but more especially of the 
eyelids, salivation, a cutaneous eruption, pigmentation, § loss of the 
hair and nails, paralysis, convulsions, and, if its use be persevered in, 
coma and delirium may result, terminating in death. A temporary 
bronzing of the skin has been noticed in some cases. 

It is rapidly eliminated by the urine, and also by the bile, and 
even the skin, tears and saliva. The milk of nursing women to whom 
it has been administered also contains arsenic (Brouardel, Pouchet). 
After it has ceased to appear in the excretions the administration of 
potassium iodide will cause it to reappear, showing that a part of it 
remains deposited in the tissues. 

Toxicology. — In excessive doses arsenous acid is a violent poison, 
usually destroying life by gastro-enteritis, in from one to two or three 
days. Three fatal cases of arsenical poisoning have, however, been 
recently reported, in which no gastro-intestinal inflammation was found 
(J. Stewart ||). When very large quantities are taken, it sometimes acts 
on the cerebro-spinal system, producing death by narcotism in a few 
hours. Occasionally both gastro enteric and cerebro-spinal symptoms 
occur. Pain and diarrhoea are not infrequently absent, as in the cases re- 

* " Comptes Rendus des Sciences," II, 6ieme ser., p. 304. 
f Arch. filr. exper. Pathol, it. PharmakoL, II., p. 89. 
% Arch. filr. exper. Pathol, u. Pharmak., 1878-9, p. 213. 
\ N. Y. Med. Record, April 12, 1890, Wehlau. 
|| Med. News, March 17, 18S8, p. 304. 



AL TERA TIVES—PREPARA TIONS OF ARSENIC. 473 

ported by Taylor (loc. cit). Poisoning by arsenic is common with such 
preparations as Rough on Rats and Paris Green, which are used to kill 
insects and vermin, and which can be obtained without difficulty. 

Two grains of arsenous acid have proved fatal, though much 
larger amounts have been taken with impunity, as in the case of a 
woman* who swallowed 5ij, and who recovered after being vomited 
with tartarized antimony. Very large quantities often cause emesis, 
which removes the poison from the stomach. M. Brouardelf records 
a case of death of a nursing infant, following symptoms of arsenical 
poisoning in its wet nurse, who, however, recovered. Pie considers it 
dangerous to administer arsenic to wet nurses, as the lacteal secretion 
is active in eliminating it. Topical applications of arsenic are toxic. 

Dissections in cases of poisoning from arsenic reveal redness 
(sometimes accompanied with extravasations of blood), ulceration, soft- 
ening, effusion of lymph, and even gangrene in the alimentary canal. 
Congestions of the broncho-pulmonary mucous membrane and of the 
lungs themselves are often observed, and acute fatty degeneration of 
the liver, spleen, kidneys, etc., is often seen, even when the poisoning 
has existed for a few hours only. The blood is often fluid and dark- 
colored. It has been shown experimentally that arsenic in solution 
injected into the mouth, rectum or vagina after death will diffuse itself 
through the body and may be found in the liver, lungs, kidneys and 
even in the brain — a point of great importance in legal medicine.J 

Antidotes and Treatment in Cases of Poisoning. — The evacu- 
ation of the contents of the stomach by emetics or by the stomach- 
pump, if seen very soon after swallowing the poison, should be the 
first object in these cases. Demulcent drinks are to be also freely 
given. The ferric hydrate (Ferri Oxidinn Hydratum) should be 
administered, as soon as it can be procured, in the state of pidp or 
magma. It is prepared by the action of an alkaline solution on a 
ferric salt. Ammonia water is directed by the U. S. P. to be added to 
the solution of ferric iron {set ferric hydrate). The ferric hydrate is a soft, 
moist, reddish-brown magma, which acts as an antidote to arsenous 
acid by forming with it an insoluble, inert ferrous arseniate (Fe 2 As0 4 ). 
The dose is about twelve times the supposed amount of poison taken, 
and it should be given in the fresh and pidpy state, as it gradually loses 
its antidotal virtues when kept. The ferric hydrate with magnesia 

* Guy's Hosp. Rep., 1851, p. 203; Taylor. 

f " Societe de Med. Legale," 1885. 

XJourn. Amer. Med. Associate Aug. 4th, 1883. 



474 MATERIA MEDICA AND THERAPEUTICS. 

[Ferri Oxidum Hydratum cum Magnesia) is also directed to be kept in 
the shops as an antidote to arsenic. It should be administered in the 
same manner as ferric hydrate, and possesses the advantage of a ten- 
dency to act on the bowels. 

Dialyzed Iron is also an antidote to arsenic in the stomach. To 
insure its conversion into ferric hydrate, its ingestion should be 
followed by the administration of a tablespoonful of sodium chloride. 
Light magnesia (which has not been too strongly calcined) and 
freshly-precipitated gelatinous magnesia may be also used as antidotes. 
The after-treatment consists in the use of demulcents, opiates, cathar- 
tics, and, if necessary, stimulants. 

Medicinal Uses. — Arsenous acid is a very valuable alterative 
remedy, but it must be exhibited with caution. It is employed with 
the greatest success in the treatment of chronic malarial affections, as 
dumb-ague, especially such cases as have resisted the use of quinine, 
or have frequently reappeared. For this purpose it should be given 
in the dose of gr. tV-tV in pill thrice daily, after meals, and the quantity 
gradually pushed until some evidence of its effects is obtained. When 
the point of toleration is reached, the size of the dose can be regulated 
so that the medicine may be safely taken for a considerable period. 

In chronic cutaneous affections, particularly the scaly diseases, lepra, 
squamous eczema, psoriasis and phthiriasis, it is highly useful, but it should 
not be given while any acute inflammatory symptoms are present, or 
where there is much itching, burning, or heat of skin, as under these 
circumstances it is apt to increase the affection. Pemphigus is often 
benefited and sometimes cured by the judicious administration of the 
arsenical preparations, as are also certain cases of acne, especially 
when occurring on the face and characterized by numerous, finely 
papular lesions. A course of arsenic, too, is indicated in the herpes 
that attacks the oral cavity in the form of cankers. It is also fre- 
quently beneficial in chronic eczema, boils, and lichen. As arsenic exerts 
its influence on the rete mucosum particularly, it is more efficacious 
when the superficial layers of the skin only are involved. 

It is prescribed also in certain affections of the nervous system, 
chorea in particular, over which it exercises a marked control in the 
form of Fowler's solution beginning with 1TLv, t. d., and increasing by 
Tflj daily till Ttlxv are reached, and suspending it for a few days when 
physiological effects manifest themselves. When these have subsided 
the dose where left off should be gone on with again. In neuralgia 
it is often of great value, especially when combined with iron and 



ALTERATIVES—PREPARATIONS OF ARSENIC. 475 

quinine; in angina pectoris during the attack, Fowler's solution, TTLv-x, 
after meals, t. d., is often serviceable ; in locomotor ataxia in full doses 
it is said to do good; in chronic rheumatism, rheumatic arthritis ; in irri- 
table dyspepsia, gastric ulcer, chronic diarrhoea, bronchitis , phthisis (where 
there is not much hectic, nor rapid disintegration of tissue), and, as a 
tonic generally, especially when anczmia is present, it is often com- 
bined with iron and quinine : ^ Acidi arsenosi, gr. j ; quininae 
sulphatis, gr. xxiv ; ferri sulphatis exsiccati, gr. xij ; oleo-resinae 
capsici, gr. iv. M. — Et ft. pil. xxiv. Sig. — One pill may be taken 
immediately after meals three times a day. In pernicious ancemia, 
arsenic is the only remedy worthy the name, and Osier * reports two 
recoveries under its employment. 

As a topical application, arsenous acid has been applied to indo- 
lent sinuses, lupus, onychia maligna, etc., either pure or mixed with 
several parts of sulphur ; when thus used, it should be applied freely? 
as a large amount is more likely to render absorption impossible, by 
the rapid destruction of the tissues which it causes. A minute crystal 
of arsenic moistened with creasote on cotton will deaden the pain in the 
cavity of a carious tooth. It is an ingredient of various empirical com- 
pounds employed in the treatment of cajicer. 

Administration. — Dose, gr. xVrV, in granules, to be reduced 
when conjunctivitis appears, and suspended after the establishment of 
the oedema arsenicalis ; and, after being taken a fortnight, it should 
always be intermitted for a day or two. It is less apt to occasion 
gastric irritability when given immediately after a meal. The usual 
and safer form of exhibiting this remedy is that of solution with potash. 

Liquor Potassii Arsenitis {Solution of Potassium Arsenite\ or 
Fowlers Solution, 

Preparation and Properties. — This is prepared by boiling I 
part of arsenous acid and 2 parts of potassium bicarbonate in 10 
parts of distilled water, and when dissolved, adding 3 parts of com- 
pound tincture of lavender, and water enough to make the solution 
weigh 100 parts ; allow the solution to stand for eight days and then 
filter. It is a transparent liquid, of an alkaline reaction, and has the 
color, taste and smell of spirit of lavender. 

Incompatibles. — It is decomposed by the reagents which act 
upon arsenic, and is incompatible with infusions and decoctions of 
cinchona, and the neutral salts of quinina and morphia. 

* Practice of Medicine, p. 695. 



476 MATERIA MEDIC A AND THERAPEUTICS. 

Medicinal Uses. — Its effects and uses are analogous to those of 
arsenous acid, though some practitioners have denied their thera- 
peutic identity. The treatment in acute poisoning is the same as that 
for arsenous acid. 

Fowler's solution is administered internally in the same diseases 
in which arsenous acid is given. When arsenic is to be prescribed 
for a long time, the acid itself should be selected, but when used for a 
short period, or to produce a constitutional impression rapidly, the 
more soluble arsenical preparations are preferred (Fowler's solution, 
sodium arsenate, or its solution, etc.). The solution of potassium 
arsenite is the most available form of arsenic for administration in the 
various forms of chronic skin-diseases which have already been alluded 
to, and may be advantageously combined with the bitter wine of iron, 
which will often prevent the gastro-intestinal derangement which is 
otherwise likely to ensue. The average dose in these cases is TTLij-iv, 
t. d., prescribed with food or directly afterward, always carefully 
watching and guarding against the supervention of toxic symptoms. 

It is a good tonic, also, in anosmia, and in chlorosis especially, 
when the subject is a young girl just arriving at the age of puberty, 
where iron disorders the digestion, or where the early stage of tuber- 
culosis is suspected. It is well to administer it for a week or more 
continuously, and to alternate with a less soluble form of arsenic. 

In irritative dyspepsia, Hlj-ij well diluted, before meals, is of great 
value. In gastric ulcer* the same treatment is recommended, com- 
bined with a milk diet and regulation of the bowels. It appears to 
lessen the amount of sugar in the urine in diabetes mellitus. A course 
of Fowler's Solution in such chronic affections as spinal sclerosis, 
hypochondriasis , Hodgkin's disease, leukcemia and melancholia, when 
other means have failed or as an adjuvant to them, may prove bene- 
ficial. As a tonic it is well combined with syrup of calcium lacto- 
phosphate. For hypodermic solution of, see Appendix. 

Administration. — Dose, Tflj-x, t. d., administered in aqueous 
solution^ after meals. Each fluid-drachm contains of arsenous acid, 
gr. t 6 o. It may be prescribed with tonics as tincture of nux vomica. 

Sodii Arsenas {Sodium Arsenate) (Na 2 HAs0 4 +7H 2 0). 

Preparation and Properties. — This is made by melting together 
arsenous acid, sodium nitrate and sodium carbonate, then dissolving 
the fused salt in boiling water, and afterward crystallizing. In this 

* Brit. Med. Journ., 1884, p. 1203, Strahan. 



AL TERA TIVES—PREPARA TIONS OF ARSENIC. 477 

process the arsenous acid is oxidized into arsenic acid by the nitric 
acid of the sodium nitrate, and then combines with the soda of 
both salts to form colorless, transparent, prismatic crystals, slightly 
efflorescent, very soluble in water, of a somewhat saline, slightly 
acrimonious taste. 

Medicinal Uses. — This salt is employed to fulfill the therapeutic 
indications of the other arsenical preparations, and has the advantage 
of a somewhat milder local action. 

Administration. — Dose, gr. xV-i, in granules. It is prescribed 
sometimes topically in the form of baths, in chronic arthritic rheumatism 
and gout y 5ss-iij in each bath. It is generally used internally in the 
form of — 

Liquor Sodii Arsenatis [Solution of Sodium Arsenate), made by 
dissolving I part of sodium arsenate (rendered anhydrous at a heat 
not exceeding 300 ) in 99 parts of distilled water ; dose, gtt. x-xx, 
mixed with water. Cigarettes made of paper saturated with a solution, 
two or three times the official strength, are smoked in asthma. 

Liquor Acidi Arsenosi [Solution of . Arsenous Acid) (formerly 
called solution of arsenic chloride) is made by boiling 1 part of arsenous 
acid with 5 parts of diluted hydrochloric acid and 25 parts of dis- 
tilled water, until the acid is dissolved, and adding to the solution, 
when cold, water enough to make it weigh 100 parts. Dose, the 
same as that of Fowler's Solution (q. v.), than which it is thought to 
be less apt to disturb the stomach. 

Arseni Iodidum [Arsenic Iodide) (Asl 3 ), made by rubbing 5 parts 
of iodine and 1 part of arsenic together, is an orange-red crystalline, 
volatilizable solid, wholly soluble in water, and has been used both 
internally and topically in skin-diseases. Dose, gr. }&, t. d., in pill or 
disguised in water; for external use, gr. iij to lard oj. 

Liquor Arseni et Hydrargyri Iodidi [Solution of Arsenic and Mer- 
curic Iodide). — This solution, known as Donovan s Solution, is pre- 
pared by dissolving 1 part of arsenic iodide and mercuric iodide, each, 
in enough distilled water to make the solution weigh 100 parts. It is 
merely an aqueous solution of the two iodides (Asl 3 and Hgl 2 ). It 
has a pale-yellow color and a slightly styptic taste. 

Incompatibles. — It is incompatible with the salts of the alkaloids 
and the alkalies. 

Effects and Uses. — This is a valuable alterative preparation in 
the various forms of papular and scaly cutaneous affections, as psoriasis 
and phthiriasis, and in obstinate syphilis. It was introduced by Mr. 



478 MATERIA MEDIC A AND THERAPEUTICS. 

Donovan, of Dublin, in 1839, an ^ nas been a good deal employed in 
the United States. 

Administration. — Dose, gtt. v to xx or more, t. d., given dis- 
guised in water. 

CALCII PHOSPHAS PRiECIPITATUS-PRECIPITATED CALCIUM PHOSPHATE. 

Preparation. — This salt is made by reacting upon bone-ash with 
hydrochloric acid, which dissolves the calcium phosphate in the bones, 
and gives it up again on the addition of water of ammonia. It is a 
white, inodorous, tasteless, insoluble powder, sometimes called the 
bone phosphate of calcium (Ca 3 (P0 4 ) 2 . 

Effects and Uses. — It is a valuable medicine, not only in dis- 
eases of deficient ossification, as ununited fractures , caries of the bones, 
rickets, etc., but in all conditions of defective cell-growth and malnu- 
trition, from its undoubted influence in promoting natural cell-growth 
and nutrition. Thus it is employed (often in connection with other 
phosphates, as those of iron, sodium and potassium) in scrofula, phthisis, 
ancemiciy diarrhoea, chronic bronchitis, abscesses, prolonged suppurations, 
and wasting diseases of every kind. On account of its insolubility it 
is apt to form intestinal concretions. 

Administration. — Dose, gr. v-x, given dusted into a little milk. 
A better (because more soluble) preparation is the syrup of calcium 
lactophosphate (syrupus calcii lactophosphatis), containing lactic acid, 
calcium phosphate, orange-flower water, sugar, hydrochloric acid, 
ammonia water and water. An emulsion containing 50 per cent, of 
cod-liver oil with syrup of the lacto-phosphate is an excellent prepa- 
ration. Dose, f5j-iv. 

CALCII hypophosphis-calcium hypophosphite. 
the hypophosphites and their preparations. 

Preparation. — This salt is prepared by boiling phosphorus in a 
mixture of calcium hydrate in water; phosphoretted hydrogen 
escapes, and calcium hypophosphite is formed in the liquid, from 
which the undissolved and residuary lime is separated by filtration, 
and the hypophosphite Ca(PH 2 2 ) 2 afterward crystallized out in the 
form of white, pearly crystals, of a nauseous, bitter taste, soluble in 
six parts of water, and insoluble in strong alcohol. 

Incompatibles. — All the soluble phosphates and carbonates pro- 
duce precipitates with calcium hypophosphite. The potassium and 
sodium hypophosphites are incompatible with the soluble salts of 



ALTERATIVES— CALCIUM CHLORIDE, 479 

mercury and silver. Potassium chlorate is a dangerous combination 
with the hypophosphites. 

Potassii Hypophosphis [Potassium Hypophosphite) (KPH 2 2 ) is 
prepared by mixing solutions of calcium hypophosphite and potas- 
sium carbonate. It occurs in white, opaque, confused crystalline 
masses, having a disagreeable, bitter taste, very deliquescent and very 
soluble in water and alcohol, but insoluble in ether. 

Sodii Hypophosphis (Sodium Hypophosphite) (NaPH 2 2 +H 2 0) 
is prepared by mixing solutions of calcium hypophosphite and crys- 
tallized sodium carbonate, and crystallizes in white tables of a pearly 
lustre, very deliquescent (but less so than potassium hypophosphite), 
very soluble in water and alcohol, and insoluble in ether. 

Medicinal Uses. — The hypophosphites have been introduced in 
the treatment of phthisis under an impression that they prove useful 
by furnishing phosphorus to the tissues. They more probably act by 
stimulating cell-growth and nutrition, and may be given to fulfill the 
same indications as the precipitated calcium phosphate. 

Administration. — Dose, gr. x-xxx, t. d. : Often prescribed with 
cod-liver oil. The calcium hypophosphite is the most eligible salt, 
but they are often prescribed together in the form of — 

Syrupus Hypophosphitum {Syrup of Hypophosphites) consisting of 
calcium hypophosphite 45 parts, sodium and potassium hypophosphites 
each [5 parts, spirit of lemon 5 parts, of sugar 500 parts; the whole 
dissolved in water 1000 parts. It is a good preparation to fulfill the 
indications of the hypophosphites. 

Administration. — Dose, f5j-ij. 

Syrupus Hypophosphitum cum Ferro (Syrup of Hypophosphites 
with Iron) contains ferrous lactate 1 part, potassium citrate 1 part, 
dissolved in syrup of hypophosphites, q. s. ad 100 parts. It is used 
for the same purposes and in the same doses as the last preparation. 
Ferric hypophosphite has been noticed with chalybeates (see index). 

CALCir CHLORIDUM— CALCIUM CHLORIDE. 

Preparation. — This salt (CaCl 2 ) is prepared by neutralizing 
hydrochloric acid with chalk or white marble, and adding a little 
chlorinated lime and slaked lime. It is a colorless, translucent salt, 
very deliquescent, readily soluble in both water and alcohol. It 
should not be confounded with chlorinated lime, which is also some- 
times called " chloride of calcium," or chloride of lime. 



480 MATERIA MEDICA AND THERAPEUTICS. 

Ixcompatibles. — Dilute H 2 S0 4 , ammonium carbonate, sodium 
phosphate and argentic solutions. 

Medicinal Uses. — This is a powerful germicide, a solution of i 
to 2000 destroying the cholera spirillium and typhoid bacillus in 2 
hours (Bolton). It resembles the calcium preparations generally in its 
effects, and is an efficient remedy in all scrofulous .affections of chil- 
dren, as glandular enlargements, accompanied by colliquative diar- 
rhoea, a coated tongue and fetid breath (Coghill*). Milk is a good 
vehicle in which to give it. It is also given with benefit in wasting 
diseases generally and in phthisis. A y 2 to I per cent, solution will 
disinfect the stools of typhoid fever and cholera. 

Administration. — Dose, gr. v-xx.; rarely used. Being deli- 
quescent, it should be kept in well-stoppered vials. 

POTASS1I CHLORAS-POTASSIUM CHLORATE. 

Preparation, Properties and Tests. — This salt is prepared by 
various processes : a good one is by reaction upon solution of caustic 
potassa, mixed with lime, with a stream of chlorine ; the chlorine is 
converted into chloric acid by oxygen from the lime, and the acid com- 
bines with the potassium to form potassium chlorate (KC10 3 ). It is a 
white, anhydrous salt, crystallizing in rhomboidal plates of a pearly 
lustre, and is inodorous, and of a saline taste. It is but little changed 
by exposure to the air; it is soluble in 16 parts of cold water or 2 
parts of boiling water. It is said to be soluble in all the animal fluids 
without decomposing them or undergoing change itself. Tests — 
When a few drops of H 2 S0 4 are added to KC10 3 , an explosive gas 
resembling chlorine is evolved. Potassium chlorate heated in a test 
tube yields oxygen. 

Incompatibles. — It should not be prescribed in powder with the 
metallic sulphides, sulphur, glycerin, the hypophosphites, the vegetable 
powders, as tannin and catechu, as when triturated with these sub- 
stances, or even mixed with cork or sugar, it parts with some of its 
oxygen to form explosive compounds. 

Physiological Effects. — Locally, it is detergent. In its effects 
potassium chlorate resembles the other potassium salts (see p. 253), 
especially the nitrate. Its taste is cool and saline. Introduced by the 
stomach, it is rapidly absorbed unaltered (Isambertf). When taken 

* The Practitioner, XIX, p. 247. 

•j- " Etudes clin., physiol., et chim. sur l'emp. therap. du chlorate de potassa." 1856, 
Paris. 



. ALTERATIVES— POTASSIUM CHLORATE. 481 

internally for some time, it gives a bright, arterial tinge to the venous 
blood, and reduces the volume and frequency of the pulse. It does 
not diminish the excretion of the urea, but largely increases the secre- 
tion of urine, by which it rapidly passes out of the system unchanged, 
as well as by the saliva (Rabuteau *). Attention has been called to this 
agent as a galactagogue by Harkin. f It has been pointed out by Dr. 
Jacobi that when given for some time this salt produces irritation of the 
kidneys and finally chronic tubal nephritis. The appetite is improved 
under its use, and salivation is an occasional result. 

Toxicology and Antidotes. — Large doses may be taken with 
impunity, but excessive quantities have produced fatal gastro-enteric 
inflammation. In the case of Dr. Fountain, J who died from swallow- 
ing Sj, taken to prove its inertness, violent gastro-enteritis set in, and 
at the end suppression of urine, with death in seven days. Fatal 
cases of poisoning from this salt have been reported, apparently from 
blood-poisoning, the heart and large vessels having been found filled 
with coagula. In cases of poisoning the stomach should be emptied 
and then demulcents as starch-water or arrow-root administered. 

Medicinal Uses. — Its most positive remedial effects are seen, topi- 
cally, in solution, where it is an admirable wash or gargle in stomatitis, 
ulcerative stomatitis and aphthce, tonsillitis, hoarseness, ozcena, the sore 
throat of scarlatina, acute and chronic pharyngitis , diphtheria, And, fetid, 
idcerated surfaces generally. 

Administration. — Dose, internally, gr. v-xxx, three or four 
times a day in water with some pleasant vehicle, as syrup of orange. 
Troches of potassium chlorate (trochisci potassii chloratis) are official ; 
each troche contains 5 grains of potassium chlorate — serviceable in 
pharyngeal cough and hoarseness. For use, as a gargle, etc., gr. v-x, 
to water, fgi; or, in the form of steam-atomization, gr. x-xx to water, 
foj, for loss of speech, laryngitis, etc. 

Sodii Chloras [Sodium Chlorate) (NaC10 3 ). — This salt may be 
made in the same way as potassium chlorate, substituting a solution 
of soda for that of potassa. It occurs as colorless, transparent tetra- 
hedrons, permanent in dry air, odorless, with a cooling, saline taste, 
readily soluble in water ; soluble also in alcohol. 

Incompatibles. — Same as for potassium chlorate. 



* Gaz. Hebdom., v, 1 868, p. 705. 
f Bull. Gen. de Therap., ii, 1892, p. 548. 
% Am. Med. Times, 1861, p. 245. 
31 



482 MATERIA MEDIC A AND THERAPEUTICS. » 

Medicinal Uses. — In effects and uses it is similar to potassium 
chlorate, but milder in its action. It is not much used internally. 
Administration. — Dose, gr. v-xx. 

POTASSII BICHROMAS-POTASSIUM BICHROMATE. 

Source. — The chief ore from which salts containing chromium 
are obtained is chrome ironstone, found in Sweden and south-eastern 
Pennsylvania. 

Preparation and Properties. — By roasting the powdered ore 
with potassium carbonate and nitre, the (yellow) potassium chromate 
is obtained, and by acidulating a solution of this with sulphuric acid, 
the (red) bichromate is formed (K 2 Cr 2 7 ) ; it separates in orange-red, 
anhydrous, tabular crystals, soluble in water, insoluble in alcohol, and 
of a cooling, bitter taste. 

Incompatible^. — Soluble salts of mercury, silver, lead, liquor 
potassae, sodae and ammonia water, form new compounds with this 
agent and may be used as tests. 

Toxicology. — Two drachms have caused death,* while a youth f 
recovered after taking gij, though it produced severe gastro-enteric 
inflammation. Lafleur and Ruttan % report the death of an adult male 
after the ingestion of §ij. There was intense cyanosis of the surface, 
the liver and kidneys being purple, the oesophagus stained yellow, 
and the blood of a brown color. The interesting discovery was made 
that the haemoglobin was found changed to methaemoglobin, which 
may account for the quickly fatal results of this drug. 

Effects and Uses. — Potassium bichromate is antiseptic in the 
proportion of I to 909 (Miquel). It is an irritant caustic, acting in 
over-doses as a corrosive poison for which the proper antidotes are 
magnesia, soap and the alkaline carbonates. In small doses it is 
alterative. In large amounts it is emetic. T. R. Fraser § has recently 
called attention to the favorable results of the use of potassium bi- 
chromate in the treatment of dyspepsia, accompanied by nausea, vom- 
iting, and epigastric tenderness, after taking food. He cites twenty- 
eight cases, in ten of which gastric ulcer had been present. The dose 
was gr. x~2-\ t. d., in pill or water. He attributes the good effects to its 
anti-putrefactive power. 

Administration. — Topically, it is a good application, in powder 

* Woodman and Tidy, 1882, p. 169. f Guy's Hosp. Reports, 185 1, p. 214. 

% Montreal Med. Journ., Aug., 1 888. \ The Lancet, April 14, 1894. 



ANTACIDS. 483 

or in saturated solution, to warts, chancroids, etc. Dose, as an altera- 
tive, gr. I daily, in pill with some bitter extract ; as an emetic, gr. ^. 

ORDER III.— ANTACIDS. 

Antacids are medicinal agents employed to neutralize acids in the 
blood, primae viae and secretions. The alkalies and alkaline earths 
and their carbonates are the substances included in this division. The 
alkalies, in the concentrated state, destroy organization and act as cor- 
rosive poisons ; they are administered internally only in a state of 
extreme dilution. The alkaline carbonates produce a less intense 
chemical action on the tissues than the alkalies ; and the bicarbonates 
are less active than the mono-carbonates. The alkaline earths, par- 
ticularly magnesia, are less energetic in their local action than the 
alkalies proper ; and their carbonates manifest little or no chemical 
influence upon the tissues. 

When swallowed in a state of dilution, the alkaline preparations 
combine with the free acids which they encounter in the stomach. 
The salts which are thus formed, unless carried off by the bowels, are 
absorbed into the blood, and are thrown out by the secretions, espe- 
cially the kidneys. It must be remembered that, as already stated 
(see p. 253), alkalies increase acid and diminish alkaline secretions, 
when in contact with the orifices of the glands which secrete them. 
In like manner, acids increase alkaline and diminish acid secretions 
(Ringer). While in the intestines, besides neutralizing acids, the alka- 
lies also promote the digestion and absorption of fatty substances, by 
forming with them an emulsion. After absorption they exert a lique- 
facient action on the blood, and render the urine alkaline. Their 
long-continued use disorders the functions of digestion and nutrition, 
produces a chronic deterioration of the blood, and sets up a cachectic 
condition somewhat analogous to scurvy. 

In the concentrated form the alkalies are employed as escharotics. 
The various alkaline preparations are administered internally, in the 
diluted form — 1. As antacids, in stomachal vertigo, eructations, and 
dyspepsia accompanied with excess of acid in the primae viae, and they 
are probably also of advantage in dyspeptic cases, by promoting the 
digestion of fatty matters. As dyspepsia with acidity probably de- 
pends frequently on fermentation of the ingesta, due to deficient secre- 
tion of acid gastric juice, the administration of the alkalies would prove 
of advantage, not by neutralizing the acid in the stomach, but by cor- 
recting the deficiency of the secretion on which the dyspepsia depends. 



4S-A MATERIA MEDICA AND THERAPEUTICS. 

If the condition, on the other hand, depend on a profuse secretion of 
acid, then the administration of the alkalies can do nothing more than 
palliate, by neutralizing, the excessive acidity. When the alkalies are 
exhibited before meals, they increase the acid secretion of the gastric 
mucous membrane ; given after meals they neutralize the excess of 
acid. Acids taken before meals decrease the amount of acid secreted 
by the stomach ; while, if given after meals, they will supply the place 
of the acid of the gastric juice, should there be a deficiency in that 
secretion. The vegetable tonics and aromatics are frequently com- 
bined with antacids advantageously, in the treatment of heartburn and 
dyspepsia. 2. To relieve irritability of the stomach and check vomiting. 
3. As antidotes incases of poisoning from acids. 4. As antilithics, to 
neutralize uric acid when it is separated in undue quantity by the 
urine ; and also as lithontriptics , or solvents of calculi, especially urates. 
They are improper when there is a tendency to the deposition of phos- 
phates ; and in treating cases of uric acid deposit it is unnecessary to 
render the urine more than neutral, as if it be made alkaline, the phos- 
phates formed may be deposited round the uric acid calculi. 5. In 
the treatment of acute rheumatism (including endocarditis) and gout, 
where they seem to act by neutralizing the excess of uric acid with 
which the blood of gout, and probably lactic acid in the case of rheu- 
matism, is charged in these diseases, 6. To relieve irritability of the 
urinary organs — ardor urince in gonorrhoea and cystitis — by neutralizing 
the urine. 7. As diuretics. 8. As anaplastics and resolvents, in inflam- 
mation. And, 9. By many therapeutists, in diabetes mellitus, to dimin- 
ish the formation of sugar. 

The antacid preparations should be adminstered in a state of large 
dilution, with a view to facilitate their absorption, and to prevent an 
irritant and purgative action on the bowels. 

POTASSII PR^PARATA— POTASSIUM PREPARATIONS. 

The preparations of potassium employed as antacids are the 
Solution of Potassa, Potassium Carbonate and Potassium Bicarbonate. 

Physiological Effects. — The general effects of the potassium 
preparations are those previously described (see p. 253). They in- 
crease both the solid and watery portions of the urine, and in large 
doses render it alkaline. Under their use, however, the uric acid, 
either free or combined, is greatly diminished, and, it is asserted, is 
converted into oxaluric acid, which is metamorphosed into oxalic 
acid and urea. 



ANTA CIDS—PO TASSIUM PREPARA TIONS. 485 

Liquor Potassae [Solution of Potassa). 

Preparation and Properties. — This is prepared by the action 
of lime on a solution of potassium bicarbonate ; the lime abstracts 
carbonic acid from the bicarbonate, and precipitates as calcium car- 
bonate, leaving the potassium hydrate in solution; or it maybe made, 
more directly, by dissolving potassa, 56 parts, in distilled water, 944 
parts. Solution of potassa is a limpid, colorless liquid, without smell, 
of a caustic taste, an alkaline reaction, and imparts a soapy feeling to 
the fingers when rubbed with it; sp. gr. 1. 036 ; in contains 5 per cent, 
of potassium hydrate (KHO). 

Incompatibles. — With acids, acid salts, and all substances held 
in solution by the same agency ; also with the ammoniacal salts, 
calomel and corrosive sublimate. 

Aids. — Liquor sodae. 

Contraindications. — Phosphatic calculi, or the phosphatic dia- 
thesis. 

Effects and Uses. — A ten per cent, solution destroys pus cocci 
(Sternberg). The antacid, diuretic, antilithic and resolvent properties 
and indications of this preparation have already been described. Its 
taste is very acrid and caustic. It is more irritant to the stomach 
than the potassium carbonates, and is therefore less eligible for pro- 
tracted uses. To render the urine alkaline in acute cystitis, Sir H. 
Thompson prefers it to the carbonates and citrates, as it is less diu- 
retic. For the same reason and purpose it is the best remedy in 
gonorrhoea and strangury. It may be administered to neutralize gas- 
tric acidity in heartburn and eructations, possessing the advantage over 
the carbonates of not giving off carbonic acid gas. 

Toxicology and Antidotes. — In excessive quantities it acts as an 
irritant and corrosive poison ; vegetable acids should be administered 
as a chemical antidote, and oils as a protective. 

Administration. — Dose, gtt. x-xx, largely diluted with sweet- 
ened water or mucilage. Topically, it is used in a diluted state as a 
stimulant lotion in prickly heat and freckles, and to acne when the skin 
is greasy. Concentrated, it is applied as a cauterant to the bites of 
rabies. 

Potassii Carbonas (Potassium Carbonate, commonly called Salt of 
Tartar). 

Preparation and Properties. — This salt is prepared by calcining 
potassium bicarbonate, which is thus deprived of a molecule of car- 
bonic acid and reduced to the state of carbonate (2KHC0 3 =H 2 C0 3 + 



486 MATERIA MEDIC A AND THERAPEUTICS. 

K 2 C0 3 ). Potassium carbonate occurs in the form of a white, coarse, 
granular powder, of a nauseous, alkaline taste and an alkaline reaction, 
very soluble in water, but insoluble in alcohol. It is very deliquescent, 
forming, if long exposed to the air, an oily liquid with the water, which 
it attracts. It should contain not less than 95 per cent, of the pure 
salt 

Incompatibles. — Acids, acidulous salts, calcic hydrate and chlo- 
ride, magnesium sulphate, ammonium chloride and acetate, alum, 
tartar emetic, iron sulphate and tincture of ferric chloride. 

Contraindications. — Same as for liquor potassae. 

Effects and Uses. — Locally, it possesses antipruritic powers. It 
is employed as an antacid, anaplastic, diuretic, and antilithic. It has 
been found specially useful in torpor of the liver, in dyspepsia as an anta- 
cid, and as an antilithic in the uric acid diathesis. 

Toxicology and Antidotes. — In large quantities it acts as a 
corrosive poison, for which vegetable acids are the chemical anti- 
dotes. Fixed oils should be given to protect the stomach. So much 
as f Siij of a concentrated solution has been swallowed without fatal 
results. 

Administration. — The dose is gr. x-xx, in some sweetened aro- 
matic water. 

Potassii Bicarbonas (Potassium Bicarbonate). 

Preparation and Properties. — This salt is made by passing 
carbonic acid through an aqueous solution of purified pearl-ash (a more 
or less impure potassium carbonate), obtained from wood-ashes by 
lixiviation, and somewhat purified by solution in water, filtration and 
evaporation, till it is fully saturated. It occurs in transparent, colorless 
crystals, having the shape of irregular eight-sided prisms with two- 
sided summits (KHCO s ). They are inodorous, of a slightly alkaline 
taste, permanent in the air, soluble in water, and insoluble in alcohol. 

Incompatibles. — Same as for the carbonate, except no precipitate 
is formed with calomel or Epsom salt. 

Effects and Uses. — These are similar to those of the carbonate, 
but it is pleasanter in taste and less irritant to the stomach. It is much 
used in gout and the uric acid diathesis. It is a good remedy in acute 
rheumatism, in which as much as ojss may be given during the day, 
with opium to relieve pain. 

Administration. — Dose, gr. xx-5j, in water; or in compressed 
tablet. 



ANTA CIDS— SODIUM PREPARA TIONS. 487 

Fuller's alkaline * treatment of acute rheumatism consists in giving 
large doses so as to thoroughly alkalinize the system, together with 
the strictest attention to the diet and the administration of tonics, as 
quinine, as soon as the system will tolerate them. He gives of potas- 
sium bicarbonate not less than 5Jss in the first twenty-four hours, either 
alone or in combination with a vegetable acid largely diluted with 
water. When the urine becomes neutral the bicarbonate is reduced 
to a quantity just sufficient to keep it so (from 5/^-^2 thrice daily). 
Of 439 cases treated by this plan, in only 2 per cent, were cardiac 
complications discovered. Fuller's treatment is best adapted to the 
obese and plethoric. 

SODII PR^PARATA— SODIUM PREPARATIONS. 

The preparations of sodium employed as antacids are Solution of 
Soda, Sodium Carbonate, Dried Sodium Carbonate and Sodium Bicar- 
bonate. 

Physiological Effects. — The sodium preparations are analogous 
in effects to those of potassium. Ringer and Sainsbury f have shown 
that they stop the extirpated frog's heart in diastole. Schoenlein, % 
too, found that sodium x carbonate acted directly on the heart and not 
through the nerves. In regard to their relative poisonous activity, the 
former ascertained that potassium stands first, then ammonium, while 
sodium possesses only slight toxic power. Being less irritant and less 
depressing, they are better as anti-dyspeptics, and for the relief of acidity 
of the primae viae. They are inferior in gout and the uric acid diathe- 
sis, as they are less powerful solvents of the acid. Their eliminative 
action as diuretics is also more feeble. 

Liquor Sodae {Solution of Soda). 

Preparation and Properties. — This is prepared by the action of 
lime on a solution of sodium carbonate, or by dissolving soda 56 parts 
in distilled water 944 parts. It is a colorless liquid, having an extremely 
acrid taste and a strong alkaline reaction. It has sp. gr. 1.059, anc ^ con_ 
tains 5 per cent, of sodium hydrate (NaHO). 

Effects, Uses and Dose. — The dose, action, administration and 
incompatibles are the same as those of liquor potassae. 

Sodii Carbonas {Sodium Carbonate) (Na 2 C0 3 -f-loH 2 0). 

Source and Properties. — There are several sources of carbonated 
sodium. The native carbonate (called natron) is found in Egypt, Hun- 

* The Practitioner, Vol. II, p. 129. f Lancet, 1882, p. 736. 

%Arch. f. d. Ges. Physiol., XVIII, p. 26. 



488 MATERIA MEDICA AND THERAPEUTICS. 

gary and other countries. Impure soda, obtained from the ashes of 
marine plants, is termed barilla or kelp — barilla when it is derived from 
phenogamous plants growing near the sea, and kelp when procured 
from cryptogamic plants growing in the sea. Sodium carbonate is 
now, however, chiefly made by artificial means from sodium sulphate. 
It crystallizes in large, oblique, rhombic prisms, which are transparent, 
very efflorescent, of an alkaline, disagreeable taste, soluble in water, 
but insoluble in alcohol. It is apt to contain sodium sulphate and 
chlorides as impurities. 

Incompatibles. — Acids, acidulous salts, lime-solution, earthy and 
metallic salts, etc., are incompatible with sodium carbonate. 

Aids. — Liquor potassae. 

Contraindications. — Phosphatic calculi, and the phosphatic 
diathesis. 

Effects and Uses. — Sodium carbonate is less irritant and has 
a milder and more agreeable taste than potassium carbonate. Its 
effects are otherwise similar, and it is administered in the same cases. 
The following forms a good anodyne lotion {Fuller's lotioii) for inflamed 
gouty joints, and the affected joints of acute rheumatism : Sodii carbon- 
atis, 5vi ; laudanum, f gj ; glycerin, f§ii ; water, f Six. M. S. — Apply to 
joints on hot cloths. 

Toxicology and Antidotes. — In overdoses it is a corrosive 
poison, for which acids and oils are the antidotes. 

Administration. — Dose, gr. x-xxx in powder, or dissolved in 
some bitter infusion. Owing to the variable quantity of water of 
crystallization which it contains, as kept in the shops, it is best given 
in the dried state. 

Sodii Carbonas Exsiccatus {Dried Sodium Carbonate}. — This salt 
is deprived of its water of crystallization by heat, and occurs in the 
form of a white powder. Dose, gr. v-xv in pill, made with soap and 
aromatics. 

Sodii Bicarbonas {Sodium Bicarboriate) (NaHC0 3 ). 

Preparation and Properties. — It is prepared by saturating the 
carbonate with carbonic acid. It occurs usually in granular masses, 
or in the form of a white, opaque powder, of a saline taste, soluble in 
water. 

Incompatibles. — With acids, acidulous salts, lime-water, ammo- 
nium chloride, the earthy and metallic salts. 

Contraindications. — Phosphatic calculi, and the phosphatic 
diathesis. 



ANTACIDS—ALKALINE MINERAL WATERS. 489 

Effects and Uses. — Locally, it is antacid and detergent. Inter- 
nally its effects are the same as those of the carbonate, but it is less 
irritant and of more agreeable taste. It is often combined with aro- 
matics in acid dyspepsia or flatulence, and in headache due to these 
causes : 1^ Sodii bicarbonatis, 5ij ; tincturae nucis vomicae, f 5ij ; tincturae 
zingiberis, f5iv; tincturae capsici, f5j; sacchari albi, 5ss ; aquae 
menthae piperitae, q. s. f§vj. M. S. — Of this, a dessertspoonful may be 
taken three or four times a day. Sodium bicarbonate is an ingredient of 
Seidlitz powders (p. 348). A most serviceable alkaline-cleansing wash 
for chronic nasal catarrh, highly recommended by Morrell Mackenzie, 
is composed of sodii carbonatis, sodii boratis, sodii chloridi, aa gr. 
vij ; sacchari albi gr. xv. M. S. — Dissolve in half a tumblerful of tepid 
water ; to be used as a nasal douche. Topically, sodium bicarbonate 
may be sprinkled with advantage over burns and scalds ; or a solution 
of Sj^ to water Oij may be applied to the parts, on lint, to alleviate 
the pain (McClellan * and Spring f). In solution gr. v to tepid water 
f§i it is used to remove the crusts of blepharitis. Equal parts of 
it and common salt make a good application to the bites of bees, 
hornets and spiders. As a soothing nasal douche in warm water (gr. 
v-x to §i) it is serviceable in dissolving the tenacious secretions of 
nasal catarrh. 

Administration. — Dose, for an adult, gr. x-xxx, which may be 
pleasantly taken in carbonic acid water or in compressed tablet. 
Troches of sodium bicarbonate (trochisci sodii bicarbonatis) — each troche 
contains gr. iij of the bicarbonate. 

Sternberg \y J alkaline treatment of yellow fever, for which excel- 
lent results are claimed, consists in administering a certain amount of 
sodium carbonate with a minute portion of corrosive sublimate in the 
hope of destroying the specific germ of the disease which is believed 
to exist in the intestines, as follows: 3^ Sodii bicarbonatis, Siv; 
hydrargyri corrosivi sublimati, gr. y 2 , aquae, Oij. M. S. — Take 1^ 
ounces every hour. 

ALKALINE MINERAL WATERS— NORTH AMERICAN. 

St. Louis Spring (Gratiot County, Michigan). — Analyst, S. P. Duf- 
field, M. D. Temperature 50 Fahr. One pint contains chiefly sodium 
carbonate, gr. 7.684; magnesium carbonate, 1.080; iron carbonate, 
O.091; calcium carbonate, 5.019; calcium sulphate, 6.925; carbonic 

* Louisville Med. News, 1878, p. 108. f Phila. Med. Times, March, 1878, p. 273. 
% Therap. Gaz., May 15th, 1889. 



490 MATERIA MEDIC A AND THERAPEUTICS. 

acid gas, 136 cubic inches; hydrogen sulphide, trace. A strongly- 
alkaline water containing a little iron • particularly beneficial in dys- 
pepsia with acidity ; also in neuralgia and chronic rheumatism. 

Capon Springs {Hampshire County, West Virginia, elevation 1800 
feet above the sea). — Contains sodium and magnesium carbonates, also, 
iodine and bromine, and is highly charged with carbonic acid gas. 
Temp. 66° Fahr. ; has but little odor. Employed in acid dyspepsia, 
uric acid diathesis and chronic cystitis. 

Poland Spring {South Poland, Maine). — Analyst, Prof. C. F. 
Chandler. One U. S. gallon contains potassium sulphate, gr. 0.1562; 
sodium chloride, 0.2636; sodium carbonate, 0.1333; calcium car- 
bonate, 1.2287; magnesium carbonate, 0.5412; silica, 1.1197; organic 
and volatile matter, 0.2332. Total solids, 3.6759. 

Bedford Chalybeate Spring (Bedford County, Pennsylvania). — One 
U. S. gallon contains, calcium sulphate, gr. 2.741 ; calcium carbonate, 
8.885; magnesium carbonate, 1.201 ; iron carbonate, 0.442; sodium 
carbonate, 0.395 ; potassium carbonate, 0.132; sodium chloride, 0.120; 
silicic acid, 0.793 ; calcium phosphate, 0.033. Total solids, 14.942. 
Carbonic acid gas, 12 cubic in. The conditions in which this and the 
Poland Spring waters prove of service are the uric acid diathesis, chronic 
rheumatism, gout, diabetes mellitus, obesity, acute and chronic Bright 's 
disease, renal calcidi, jaundice, acute gastritis, biliary calculi, and acute 
and chronic hepatitis. 

ALKALINE MINERAL WATERS— EUROPEAN. 

Apollinaris (Valley of the Ahr, Rhenish Prussia). — One pint con- 
tains sodium carbonate, gr. 6.964*; magnesium carbonate, 2.75 1 ; 
calcium carbonate, 1.900; sodium chloride, 2.743; sodium sulphate, 
1.548; oxide of iron with alumina, 0.049 ; silicic acid, 0.099; total 
solids, 16.054. Gases: carbonic acid, free and semi-combined, cub. in. 
42.81 ; carbonic acid combined, 12.44. An agreeable and palatable 
alkaline mineral water, extensively taken as a table-water. 

Vichy (France); Ems (Germany); Fachingen (Germany). — The 
Vichy waters do not act on all alike. To some they prove purgative, 
to others diuretic; but they invariably render the urine alkaline. 
There are nine springs in all the temperature of which ranges from 53 
to 110 Fahr., and they are employed as baths as well as internally. 
Taken during or after digestion they check acidity ; administered 
before they augment the acid gastric secretion. The Ems waters 
increase the urinary secretion and perspiration, render the urine alka- 






ANTACIDS— ALKALINE MINERAL WATERS. 



491 



line, and tend to produce constipation. The Vichy waters are pre- 
scribed in dyspepsia with acidity and constipation, in acute gastritis, in 
biliary calculi, jaundice, renal calculi, gout, diabetes mellitus, obesity, 
malarial cachexia, and to neutralize the urine in strangury. In the 
treatment of diabetes mellitus the alkaline mineral waters (Sprudel 
wasser) are recommended by Dr. Lenne * as far superior to all drugs. 
The Ems waters, which are limpid and soft to the touch, are prescribed 
with benefit in chronic bronchitis, pharyngitis, chronic cystitis, and endo- 
metritis. The Fachingen waters are used in the same way as the 
Vichy. There is no resort at the Fachingen spring. 

ANALYSIS. 



ONE PINT CONTAINS 


VICHY, GRANDE 
GRILLE. 

IO5. 8° FAHR. 

BOUQUET. 


FACHINGEN 
50° FAHR. 

FRESENIUS. 


EMS, KESSELBRUN- 

NEN. 

115° FAHR. 
FRESENIUS. 


Potassium carbonate 

Sodium carbonate ....... 

Magnesium carbonate 

Iron carbonate 

Magnesium carbonate 

Calcium carbonate ...... 

Lithium carbonate 

Strontium carbonate 

Barium carbonate 

Sodium chloride 

Calcium chloride 

Potassium sulphate 

Sodium sulphate 

Sodium phosphate 

Aluminum phosphate 

Calcium phosphate 

Lithium phosphate 

Silicon phosphate 

Calcium fluoride 

Sodium biborate 

Sodium arseniate 

Silica 


grains. 
2.04 
26.00 
1.38 
0.02 
trace 
2.31 

O.OI 

4.10 
2.29 

0.78 

trace 

O.OI 

0.05 


grains. 

I9-4763 
l.358o 
0.0801 

2.1010 
0.0004 
0.0007 

4-5574 . 
0.0034 

0.1372 
0.0506 
0.0003 
0.0004 
0.0002 
0.2610 
0.0027 


grains. 

io.5379 
0.8510 
0.0202 
0.0035 
1.2591 

0.0030 
0.0030 
7.7705 

o.3937 
0.0061 

0.0096 
0.3648 




JTotal 


38.99 


27.9397 


21.2194 



GASES. 


cub. in. 


cub. in. 


cub. in. 


Carbonic acid 


14.74 


32.975 


67.88 



* Muncher Med. Wochen., 1892, p. 601. 



492 MATERIA MEDICA AND THERAPEUTICS. 



LITHII PRjEPARATA— LITHIUM PREPARATIONS. 

Source, Preparation and Properties. — Lithium is found in 
several minerals, as lepidolite, etc., but in minute amount. It is 
extracted chiefly by the agency of sulphuric acid ; the sulphate is 
converted into a chloride by a solution of barium chloride, and from 
the chloride, the carbonate (Lithii Carbonas) (Li 2 C0 3 ) is prepared by 
the addition of ammonium carbonate. It is a white powder of a mildly 
alkaline taste, soluble in 130 parts of water, more soluble in carbonic 
acid water, and insoluble in alcohol. 

Incompatibles. — With acids, acidulous salts and the agents that 
decompose the alkalies. 

Effects and Uses. — The lithium salts acton the system ma. similar 
manner to the other alkalies. Lithium carbonate is an antacid and 
solvent remedy in gout and rheumatism o'f some value, from the fact 
of its low combining number and the great solubility of the lithium 
urate, thus enabling the carbonate to act powerfully in eliminating uric 
acid from the system. Garrod* who first called attention to lithium 
in the treatment of gout, experimentally proved its efficiency as a sol- 
vent of uric acid deposits by placing a metacarpal bone and bit of 
cartilage, both of which were infiltrated with gouty nodules, in a 
solution of lithium carbonate, which in a few days dissolved away 
the deposit. The author has found it highly efficacious in the cure of 
gout. It is, too, a good diuretic. 

Administration. — Dose, gr. v-x two or three times daily, largely 
diluted and best given in carbonic acid water; or in compressed 
tablets. 

Lithii Citras (Lithium Citrate) (Li 3 C 6 H 5 7 ), a deliquescent white 
powder, soluble in 2 parts of water, is made by adding a solution of 
citric acid to the lithium carbonate. It is converted into a carbonate 
in the system, and is, therefore, possessed of the same properties, but 
is more refrigerant. Strong solutions of the lithium salts have been 
found useful externally in removing gouty enlargements. 

Administration. — Same as lithium carbonate. 

Lithii Citras Effervescens, an addition to the U. S. P. of 1890, is 
made by triturating citric acid and sugar, drying and then further trit- 
urating with lithium carbonate and sodium bicarbonate. 

Lithii Benzoas (Lithium Benzoate) (LiC 7 H 5 2 ). 

* " Gout and Rheumatic Gout," 1859, p. 435. 



ANTA CII)S— MA GNESIUM PREPARA TIONS. 493 

Preparation and Properties. — This is prepared by the gradual 
addition of benzoic acid to a heated watery solution of the carbonate, 
and evaporating. It may be obtained in the form of glistening, pearly 
scales, of a soapy feel and a cool, sweetish taste, soluble in three and 
a half parts of water at 6o°. 

Effects and Uses. — The ready solubility of this salt and its free- 
dom from deliquescence, and the benzoic acid which it contains in 
combination, give it especial value in the treatment of the various 
forms of disease dependent upon uric acid deposits. 

Administration. — Dose, gr. iij-v repeated, in solution or com- 
pressed tablet. 

lithian mineral waters. 

Ballston Spa {Saratoga County, New York). — Analysis of the 
Ballston Lithium well by Prof. C. F. Chandler; temperature 5 2° Fahr. 
In addition to lithium carbonate of which there is gr. ^ to the pint, 
this water contains a large quantity of sodium chlorine, calcium and 
magnesium carbonates. 

Saratoga Springs {New York, Pavilion Spring). — This yields in 
addition to the carbonates and sodium chloride about gr. ^ of lithium 
carbonate to the pint. 

Buffalo Lithia Springs [Mecklenburg County, Va). — The water of 
Spring No. 2 contains the alkaline and earthy sulphates and carbonates 
and lithium bicarbonate gr. 2j£ per imperial gallon. 

Londonderry Lithia Springs {Nashua, N. II.). — This water contains 
considerable quantity of calcium sulphate and potassium bicarbonate, 
and gr. 8)4 of lithium bicarbonate per imperial gallon. 

Medicinal Uses. — These waters are useful in gout, chronic 
rheumatism, and the uric acid and gouty diathesis. 

AMMONII PR.EPARAT A— AMMONIUM PREPARATIONS. 

The preparations of ammonia (previously noted under the head 
of Stimulants ^ p. 217) are administered as antacids in cases in which 
a stimulant action is not objectionable. Spiritus ammonia aromati- 
cus {aromatic spirit of ammonia) is the preparation usually employed, 
and is an excellent antacid carminative in heartburn attended with 
flatulence, nausea with syncope , etc. Dose, gtt. xxx-f5j. 

MAGNESII PRiEPAR AT A— MAGNESIUM PREPARATIONS. 

Magnesia (343) and its Carbonate (343) are employed as antacids 
in dyspepsia, sick headache, gravel etc., particularly where a laxative 
effect is also desirable. Dose, gr. x-xxx. 



494 MATERIA MEDICA AND THERAPEUTICS. 

CALCII PR^PARATA— CALCIUM PREPARATIONS. 

The preparations of calcium employed as antacids, are Lime- 
solution, Precipitated Calcium Carbonate and Prepared Chalk. 

Effects and Uses. — They are very useful in cases of acidity or 
irritability of the stomach, but their action on the bowels is the reverse 
of that of magnesia, and hence they can hardly be administered where 
there is a tendency to constipation. They are also much employed in 
diarrhoea. 

Lime {Calx, CaO) is official, but is only employed in making 
liquor and syrupus calcis. 

Liquor Calcis [Lime- Solution,' Lime-water). 

Preparation and Properties. — This is a saturated solution of 
lime in distilled water. It is a colorless, inodorous liquid, of an 
alkaline taste, containing about 0.15 per cent, of calcium hydrate 
(Ca2HO). By exposure to the air it gradually absorbs carbonic acid, 
with the formation of insoluble calcium carbonate. It should, there- 
fore, be kept in full, well-stoppered bottles, or they should contain 
some undissolved lime. 

Incompatibles. — With sulphuric acid, ammonium phosphate, 
sodium carbonate, potassium carbonate, magnesium sulphate, ammo- 
nium chloride, alum, tincture of ferric chloride, and solutions of quinine 
or morphine sulphates ; the lime carbonate with acids and acidulous 
salts. 

Contraindications. — Oxaluria. 

Effects and Uses. — Locally, it is astringent and alkaline. Liquor 
calcis possesses germicidal virtues, a 6 per cent, solution sterilizing in 
2 hours the dejecta in typhoid fever. The taste of lime-water is 
alkaline and disagreeable. I. J. Abel * finds that the urine of dogs 
fed with slaked lime gives off ammonia and carbon dioxide, and that 
the alkalinity of the urine is probably due to calcium carbonate. It 
combines antacid and astringent properties, and is applicable to all the 
cases in which antacids are proper, where an astringent effect on the 
bowels is not objectionable. It is an excellent remedy in gastric 
irritability, attended with nausea and vomiting, and may be given 
mixed with an equal part of milk, which disguises its unpleasant taste. 
A diet of milk and lime-water is very useful in dyspepsia, accompanied 
with vomiting of food. Lime-water is employed also as an astringent 

* Bulletin Johns Hopkins Hosp., Apl., 1894. 



ANTACIDS— MAGNESIUM PREPARATIONS. 495 

in acute diarrhoea after the inflammation has been subdued ; for its 
alkaline virtues in diabetes melliius, and in pyrosis. Topically, as a 
mouth wash in fetor of the breath, sordes and mercurialismus ; as an 
application to foul ulcers, and as an injection in leucorrhcea. Atomized 
inhalations of lime-solution have been found useful in diphtheria and 
membranous croup. 

Administration. — Dose, internally, fgss-iij-iv several times a 
day ; for children, f5j. Linimentttm calcis [lime- liniment) (equal parts 
of lime-solution with cotton-seed oil, sometimes called carron oil) is an 
invaluable liniment in burns and scalds. 

Syrupus Calcis {Syrup of Lime) contains 5 per cent, of lime and 
30 per cent, of sugar. It has been used as an astringent in diarrhoeas, 
and as an antidote to poisoning by carbolic acid. It is much stronger 
than lime-water, TTLxx of the syrup being equal to foj of the latter. 
Dose, f5ss-ij, well diluted. 

Calcii Carbonas Prsecipitatus (Precipitated Calcium Carbonate) 
(CaC0 3 ) is made by mixing boiling solutions of calcium chloride and 
sodium carbonate. It is a fine white powder, insoluble in water, and 
free from grittiness, but possessing no superiority over prepared chalk. 

Creta Praeparata {Prepared Clialk) (CaC0 3 ) is made from chalk or 
whiting by levigation and elutriation. It occurs in little white conical 
loaves, which are tasteless, odorless, insoluble in water, but soluble in 
carbonic acid water. 

Effects and Uses. — Its effects are those of an antacid and 
de sic cant astringent. It is prescribed in dyspepsia and gout attended 
with an excess of acid in the system ; also in diarrhoea ; and as it 
forms soluble calcium salts with the acids of the stomach, its employ- 
ment has been suggested in rickets. Topically, it is used as a dusting 
powder on chafed spots. 

Administration. — Dose, gr. x-xxx, in powder or suspended in 
water with acacia and sugar. Compound clialk- pozvder (pulvis cretce 
compositus) is made by mixing prepared chalk (30 parts) with powdered 
acacia (20 parts), and sugar (50 parts); dose, gr. x-xxx. Chalk-mixture 
(mistura cretce) consists of compound chalk-powder (20 parts) mixed 
with water and cinnamon-water (40 parts of each) ; dose, foss, repeated. 
Laudanum and tincture of kino or of catechu, and aromatics, are often 
added to this mixture in the treatment of acute diarrhoea. Troches of 
chalk (trochisci cretce) are made by mixing prepared chalk, acacia, 
nutmeg and sugar, and forming a mass with orange flower water and 
water ; each troche containing gr. iv of prepared chalk. 



496 MATERIA MEDICA AND THERAPEUTICS. 

CALCAREOUS WATERS-NORTH AMERICAN. 

Catoosa Springs {Catoosa County, Georgia), contain calcium sul- 
phate gr. 39, with magnesium sulphate and carbonate gr. 34, and car- 
bonic acid gas gr. 4^ to the gallon. 

Tate Epsom Springs {Granger County, Tennessee). — Calcium sul- 
phate is the chief ingredient, gr. 160 to the gallon; also Epsom and 
common salt. Temperature, 55 Fahr. 

CALCAREOUS WATERS— EUROPEAN. 

Contrexville and Bagneres-de-Bigorre {France), Leuk (Szuitzerland), 
and Wildungen {Germany). — The most important ingredients in these 
waters are calcium carbonate and sulphate with small quantities of 
iron carbonate and carbonic acid gas. Their temperature varies, 
Contrexville being 54 Fahr., and Leuk, the highest, 123 Fahr. 
The Contrexville water is highly diuretic and diaphoretic, producing 
some phenomena of excitement. The stools are more frequent, being 
watery and bilious. It is particularly useful in the uric acid diathesis, 
gravel, renal calcidi, gout and chronic cystitis. Their good effects seem 
to be due to a thorough flushing out of the urinary apparatus more 
than to anything else. The waters of Bagneres-de-Bigorre are reputed 
sedative in nervous conditions; but the fresh mountain air of the 
neighborhood may have something to do with it. Those of Leuk, 
which, on account of their high temperature, act freely on the skin, are 
employed in the form of baths for the treatment of cutaneous maladies, 
as lichen, chronic eczema, psoriasis and phthiriasis. The Wildungen 
water is used in the same affections as the Contrexville. 



CLASS IV.— TOPICAL MEDICINES. 

ORDER I.— ANTISEPTICS AND ANTIPYRETICS. 

Antiseptics (dure, against, and (rrjuro^, putrid) are agents which 
destroy (by Sternberg * restrain) the vitality of the microorganisms 
which produce septic decomposition. Germicides or disinfectants are 
substances which completely kill the living disease-germs or patho- 
genic bacteria in infectious material. All agents destroying the vitality 
of putrefactive bacteria possess alike disinfectant and antiseptic proper- 
ties, since they destroy the vitality of the bacteria upon which these 

*" Manual of Bacteriology," p. 156. 






ANTISEPTICS AND ANTIPYRETICS. 497 

processes depend. On the other hand, all antiseptics are not germi- 
cides, since germicidal agents producing antisepsis (salt and water for 
example) do not always kill germs. Antipyretics (dure, against, and 
Ttupsroz, fever) are those which reduce the temperature of the body, 
such action being particularly conspicuous when the body-heat is ele- 
vated by a febrile process, and almost nil in the normal state. 

The antiseptic and the antipyretic properties of many substances 
of this group bear a definite relation to each other, so that they are 
powerful in lowering febrile temperature in the same ratio as they are 
destructive to lower forms of life, and especially is this the case with 
the lower members of the aromatic series of carbon compounds. 

The theory of putrefaction which, based upon the researches of 
Pasteur, has been steadily gaining ground and is now univer- 
sally adopted, refers the changes which take place in decomposing 
matter to the agency of organized germs ever present in the atmos- 
phere, which, finding a suitable nidus in putrescible material, grow and 
multiply, producing chemical decomposition as a result of their pres- 
ence. As in many diseases (e. g. t relapsing fever, diphtheria, etc.) 
certain organized germs have been found to take an essential part in 
the diseased process, if not to produce it, and as their presence is sus- 
pected in many diseases in which as yet they have not been demon- 
strated to exist, the importance of a group of agents which are destruc- 
tive to these low forms of life can hardly be exaggerated. The extent 
to which this group of remedies will destroy disease-germs in the 
body without injuring the vitality of the human being, cannot be defi- 
nitely laid down. Certain it is that as yet we possess very few specifics 
in medicine, especially against the zymotic diseases, which would 
appear a- priori to be especially the class to which antiseptics would 
apply. Yet, as many antiseptics are also antipyretics, they are not 
without use in the diseased economy, even if they do not cut short the 
morbid process. 

When applied topically antiseptics are of great value, not only as 
deodorants and disinfectants, but also as germicides in dressing wounds, 
ulcers, etc., as in Sir Joseph Lister's antiseptic method or its various 
modifications. They are also useful to prevent the spread of disease 
when added to the excreta of patients suffering from contagious 
affections. 

Antipyretics act * chiefly either to lessen the production of heat 

*'-'A Text-book of Pharmacol., Mat. Med. and Therapeut." London, 1885, pp. 53 
and 366. By T. Lauder Brunton. 
32 



498 MATERIA MEDICA AND THERAPEUTICS. 

by retarding oxidation, and consequently cell-proliferation and 
chemical and molecular changes in the tissues, or by depressing the 
circulation either of the part (local abstraction of blood, blisters, 
etc.), or of the system at large (sedatives) ; or increase the loss of heat 
by increasing the evaporation of perspiration from the surface (dia- 
phoretics) ; by dilating the cutaneous vessels and thus promoting 
heat-radiation (alcohol, amyl nitrite, spirit of nitrous ether), or by 
abstracting heat directly from the surface (cold applications or 
drinks). Many of the antipyretics (e. g., sedatives, sudorifics, quin- 
ine, etc.), as well as of the antiseptics (alcohol, iodine, quinine and 
solutions of various metallic salts), have already been discussed, and 
it now remains to study those articles of the former group which 
are used to lessen heat production chiefly by retarding oxidation, 
as well as those remedies particularly employed as topical antiseptic 
agents. 

POTASSII PERM ANGANAS— POTASSIUM PERMANGANATE. 

Preparation and Properties. — This salt is made by mixing 
together equal parts of manganese dioxide and potassium chlorate, 
dissolving in a little water, evaporating to dryness, and exposing to a 
nearly red heat. Potassium permanganate (KMn0 4 ) occurs in the 
form of slender prismatic crystals, of a deep purple color, inodorous 
and of a sweetish, astringent taste. It dissolves readily in water, 
making a beautiful lilac-solution. 

Incompatibles. — With syrup, sugar or glycerin, as parting with 
its oxygen readily, explosion or fire may result ; also with organic 
matter and Fowler's solution, which decolorize it. 

Effects and Uses. — Locally, potassium permanganate is irritant ; 
in solution, stimulant. Upon the products or action of sepsis by part- 
ing readily with oxygen, it either destroys the principle on which this 
action depends, or unites to form new chemical compounds, incapable 
of further decomposition; hence its antiseptic powers. In virtue of its 
oxidizing property it is deodorant, disinfectant and detergent. By 
Sternberg it is stated to be germicidal, and it destroys the pus cocci in 
bouillon in the proportion of I to 833 in 2 hours. In solution it has 
a disagreeable taste. There is little experience as regards the action of 
this salt when administered internally. It is given with success in 
amenorrhoea (Ringer), especially when of a purely functional character, 
and for this purpose it maybe administered in gelatin-capsules, gr. j-ij, 
t. d., taken for five days or a week before the expected period. It has 
been introduced as a remedy in the, flatulent dyspepsia of obesity. It is; 



ANTISEPTICS AND ANTIPYRETICS. 499 

however, as a powerful disinfectant that it claims chief attention, and 
it now ranks at the head of this class of agents in destroying fetid odors 
and poisonous organic emanations. Its power in this respect is due 
to the evolution of oxygen in its more active form, ozone. It has been 
brought forward as an antidote to opium poisoning, but without suffi- 
cient proof. 

External Uses. — It is used topically in dressing foul and fetid 
or gangrenous ulcers, as an application to carbuncles, as a gargle in 
diphtheria, as an injection into the cavity of abscess, and bubo, and in- 
jected into the wounds caused by the bites of insects or venomous sytakes. 
In the form of spray it is useful against the parasite of thrush. It may 
be sprinkled in powder on gangrenous surfaces, phage dcena, or applied 
in solution of the strength of 5^j-ij to a pint of water. As a disi?zfectant 
and deodorizer, in the stools of typhoid fever, etc., a solution of from one 
to ten grains to an ounce of water is used ; and it may be exposed in sau- 
cers or sprinkled on the floor, or thrown into the air in spray by the 
atomizer. As an injection in gonorrhoea potassium permanganate (gr. 
ij to water fSj) is highly efficacious, especially where a profuse yellow- 
ish discharge exists. In using this remedy, care must be taken to 
avoid the introduction of organic matter into the solution, which, by 
reducing the salt to an oxide, will destroy its efficiency. A good plan 
is to make the solution as required. Milton* states that nothing 
approaches it in point of efficiency as an injection in gonorrhoea. In 
the same way it may be employed in gonorrhoea of the female and 
urethritis. 

Administration. — One to three grains may be given internally 
made into pills with cacao-butter and vaseline, or taken in gelatin-cap- 
sules through the day. Condfs Fluid contains gr. ij to the f§j. It is 
used for a variety of purposes where a disinfectant and deodorizer are. 
indicated, as bedsores, a wash in ozoena, a mouth-wash in sordes, fetor of 
the breath, and to correct fetor of the feet. 

AQUA CHLORI— CHLORINE-WATER. 

Description and Properties. — This is an aqueous solution of 
chlorine, and should be kept in a cool place, protected from the light, 
but it is soon decomposed. It contains at least 0.4 per cent, of the 
gas. It occurs as a greenish-yellow liquid, having an astringent taste 
and the suffocating odor of the gas. 

*" On Gonorrhoea," etc., 1887, P- 20I « 



500 MATERIA MEDICA AND THERAPEUTICS. 

Incompatibles. — The salts of silver and lead. 

Effects and Uses. — Chlorine acts as a germicide and deodori- 
zer, chiefly by its affinity for the hydrogen of moisture, the sulphur- 
etted hydrogen, and ammoniacal products of decomposition, and the 
liberation of oxygen ; its gaseous form gives it advantages in this 
respect. Applied to the skin it is a powerful rubefacient and vesicant. 
Chlorine vapor is extremely irritant to the respiratory mucous mem- 
brane. Internally, its taste is astringent. Upon the stomach its action is 
irritant. As chlorides and HC1 are formed, it is unlikely that the gas as 
such reaches the tissues through the blood. It is seldom used inter- 
nally. Topically, it is employed, diluted, as a wash in parasitic skin- 
diseases, and as an antiseptic. 

Toxicology. — In case of poisoning by chlorine-water albumen is 
the best antidote ; as a vapor, steam inhalations. 

Administration. — Dose, f5j-iv, diluted. It should be kept in 
dark, glass-stoppered vials. 

calx chlorata-chlorinated lime. 

Preparation and Properties. — This agent, often improperly 
called chloride of lime, is prepared by passing chlorine over calcium 
hydrate till saturation is effected, and is said to be principally a mix- 
ture of calcium hypochlorite and chloride (CaCl 2 2 and CaCl 2 ). It 
occurs as a loose, grayish- white powder, or friable lumps, dry or but 
slightly moist, readily soluble in water, of a bitter, caustic taste and a 
faint odor of chlorine. Exposed to air and moisture, it slowly yields 
hypochlorous acid (HCIO), and this soon breaks up into water, chloric 
acid (HCIO3), and free chlorine, and the chloric acid again yields 
chlorine; 35 per cent, of chlorine should be furnished by good chlor- 
inated lime. 

Effects and Uses. — Its effects are essentially those of chlorine. 
It is only as a disinfectant for cesspools, etc., that it is employed. 

Liquor Sodae Chloratae {Solution of Chlorinated Soda), sometimes 
termed Labarraque 's Disinfecting Liquid. 

Preparation and Properties. — This is made by decomposing a 
solution of sodium carbonate by one of chlorinated lime. It is a 
transparent, greenish-yellow liquid, with a faint smell of chlorine, a 
sharp saline taste and an alkaline reaction. Locally, it resembles aqua- 
chlori, though feebler. It is useful, in dilution of various strengths, as 
a topical application to every form of fetid ulcer, and is a most valuable 
and powerful disinfectant. 



ANTISEPTICS AND ANTIPYRETICS. 501 

Hydrargyri Chloridum Corrosivum {Corrosive Mercuric Chloride'). 

Effects and Uses. — Corrosive sublimate, one of the most power- 
ful bacteriacidal drugs known (q. v.), is very destructive to the lower 
forms of life, and is largely used for this purpose in the treatment of 
various surgical affections. A solution of I to 10,000 kills the spores 
of anthrax in two hours, while I to 1000 destroys almost at once the 
most powerful organisms (Koch). Sternberg * found that I to 30,000 
restrained the development of pus cocci, and Schill and Fischer ascer- 
tained that a solution of I to 2000 failed to disinfect tuberculous 
sputum. The presence of albumen diminishes the germicidal power of 
solution of HgCl 2 by the formation of a mercury albuminate ; the 
alkalies and carbonates likewise reduce its potency. But the addition 
of a mineral acid or NaCl (5 parts) prevents the precipitation by 
albumen or the alkalies. It is employed in solutions (1 to 1000, - 
I to 8000) as a prophylactic to cleanse the surface of the patient, and 
the hands, instruments, and sponges of the surgeon, previous to an 
operation, and in the form of corrosive sublimated gauze, or cotton, as 
a dressing after the operation is finished, and thus prevent the entrance 
of the germs on which depend suppuration, erysipelatous, or diph- 
theretic inflammation, and other complications of wounds. Solution 
of corrosive sublimate may induce considerable irritation upon a deli- 
cate skin, and it occasionally produces toxic symptoms when used to 
flush out serous cavities, unless all the fluid be removed. 

To destroy germs when already present, it is also useful. Thus, 
in the treatment of abscesses, either acute or chronic, after evacuating 
the contents through a small incision, the cavity should be super- 
distended with the corrosive sublimate solution (1-1000 or 1-2000) 
and the fluid retained from two to five minutes, when it should be 
allowed to drain off, after which the injection is to be repeated until 
the fluid flows away as clear as when introduced. In this way we 
destroy the protophytes on which these forms of suppuration depend, 
and thus hasten the growth of granulations. In psoas, iliac or lumbar 
abscess, this method of treatment probably gives the best results, and 
deep-seated mammary abscesses may be rapidly healed by its employ- ' 
ment. 

As numerous cases of poisoning are recorded, it is better to 
decrease the strength of the solution or to. discontinue its use, and 
employ pressure to bring the walls of the abscess together, after a few 
days, when healthy granulations are springing up. 

*" Manual of Bacteriology," p. 183. 



502 MATERIA MEDICA AND THERAPEUTICS. 

As an injection in go <norrhoca, a weak solution (1-8000, or better, 
1-12000) may be used to destroy the gonococci, but even then severe 
pain and violent inflammation may be excited in the male urethra by 
such an injection. In gonorrhoea of the female, a corrosive chloride 
solution (1-8000) thrown into the vagina when the patient is in the 
recumbent position with the hips slightly elevated by a pillow is very 
efficacious. 

In the treatment of puerperal septicemia, vaginal and even uterine 
injections are employed, care being taken in the latter case to throw 
the solution very slowly into the uterus, to be sure that it returns freely 
through the os uteri, to avoid the introduction of air into the uterus 
and to discontinue the injection should much pain be complained of or 
symptoms of syncope or collapse supervene. 

It may be used not only as a dressing, but also as a wash for all 
wounds and ulcers whatever. 

Bed-bugs can be got rid of by scouring* the bed with corrosive 
sublimate solution. 

Administration. — A solution of the required strength may be 
made as follows: Jfy Hydrargyri chloridi corrosivi, 5j ; divide in chart, 
vnj. Sig. — One powder dissolved in a pint of hot water forms a solu- 
tion of 1 to 1000; or, as the powders are somewhat difficult of solu- 
tion, Ify Hydrargyri chloridi corrosivi, 5j ; alcohol, f§ij. M. Sig. — 
f5ij, in a pint of water = 1 in 1000 parts. If the latter solution is to be 
kept for some time, it is well to add an equal weight of ammonium 
chloride to the corrosive sublimate to prevent the decomposition of the 
latter salt. A }4 per cent, soap can be had in the shops ; useful in' 
pediculosis and various forms of tinea. 

Compressed tablets are also kept in the shops, which are very con- 
venient for making solutions. They contain gr. 7^, which make in 
water Oi, a 1-1000 solution. If mercuric chloride be used to disinfect 
instruments, they should not be allowed to remain in the solution, as 
otherwise mercury will be deposited on the surface of the metal, and 
the instrument tarnished. Gauze, lint, cotton, zvool,jute, saw-dust, etc., 
are impregnated with solutions of corrosive chloride and used as 
surgical dressings. 

Hydrogen Peroxide [Hydrogenii Peroxidum). (Not official.) 

Preparation and Properties. — This is made in the decomposi- 
tion of bai'ium dioxide (Ba0 2 ) by sulphuric acid as follows: — Ba0 2 -h 
H 2 S0 4 =BaS0 4 +H 2 2 or hydrogen peroxide. As found in the shops it 
consists of a 10-15 volume aqueous solution, colorless, slightly acidu- 



ANTISEPTICS AND ANTIPYRETICS. 503 

lous, unstable, liable to explosion, and should, as Squibb directs, be 
kept in a loosely corked vial, so that the oxygen of decomposition may 
readily leak out. 

Physiological Effects. — By Gabrieu and Dewar it is considered 
to be antiseptic. Applied to the hair it bleaches it ; within the mouth it 
produces a soapy froth. But its most peculiar effect is that it effervesces 
when mixed with pus, mucus, blood, etc , without being irritating, hence 
it is powerfully detergent. There are no data as regards its internal 
effects. It readily oxidizes organic matter. 

Medicinal Uses. — These are confined to its application in local 
therapy, where it is of service in removing pus, mucus, exudates, etc., 
before the application of other remedies. Being non-irritating and 
antiseptic, it is of service when applied to old leg ulcers, suppurating 
buboes and sinuses. In aural therapy it is of value to cleanse the canal 
in otorrhoea before the insufflation of an antiseptic powder. As a spray 
it is employed against the exudate of diphtheria * in the strength of 
25-50 volumes ; and in %-}i, dilution as an injection in gonorrhoea. 

Administration. — Aqua hydrogenii dioxidi is official. The solu- 
tion of the shops in one-fourth or half dilution is applied by atomizer, 
swab, syringe or on cotton. All solutions should be freshly made as 
they diminish in strength. 

Bromine (see Escharotics) and Iodine are antiseptics, acting in a 
manner similar to chlorine. The antiseptic value of bromine in the form 
of vapor is 1 to 666, that of iodine 1 to 4000 (Miquel). They are seldom 
used for this purpose. 

Hydrargyri Iodidum Rubrum (Red Mercuric Iodide) (q. v.) is also 
used in aqueous solution as an antiseptic (1 to 2000). It has not, 
however, replaced the mercuric chloride as a germicide. 

Acidum Sulphurosum (Sidphurous Acid) contains not less than 6.4 
per cent, of sulphurous acid gas in not more than 93.6 of distilled water, 
and is made by heating sulphuric acid with charcoal and distilled water. 
The sulphuric acid is deprived of an equivalent of oxygen by the char- 
coal, and becomes sulphurous acid (H 2 S0 3 ). It is a colorless liquid, 
having the smell of burning sulphur and a sulphurous, sour, and some- 
what astringent taste. 

Effects and Uses. — This is a powerful deoxidizing and germicidal 
agent. Sternberg found that it destroyed micrococci in two hours, in 
strength of 1 : 2000; by Kitasato 0.28 per cent, killed the typhoid 

* Am. J. Med. Sci., Oct. 1893. F. H. Williamson. 



504 MATERIA MEDIC A AND THERAPEUTICS. 

bacillus, and 0.148 per cent, the cholera spirillium. It is readily 
absorbed by the stomach, and is eliminated by the urine and faeces as 
a sulphate. Internally, it is very efficacious in sarcina ventricnli, or 
yeast vomiting; dose, f5j, largely diluted with water. Topically, it is 
used in skin-diseases of a parasitic nature, as tinea circinata and 
versicolor and favus, mopped on pure or diluted with two or three 
measures of water or glycerin. When the attacked parts are exposed, 
the face or neck for example, it possesses the advantage of not leaving 
a temporary stain. The sulphites possess in a feebler degree the 
properties of sulphurous acid. 

Sodii Sulphis [Sodium Sulphite) (Na 2 S0 3 -r-7H 2 0) is used as a sub- 
stitute for sulphurous acid, which is developed from the salt by any of 
the organic acids. It occurs in white, efflorescent, prismatic crystals, 
of a sulphurous taste, soluble in four parts of cold and one part of 
boiling water. 

Effects and Uses. — Locally, it is not germicidal, even in satur- 
ated solution (Sternberg). A solution (5j-foj of water) is a good local 
application in erysipelas and aphtha, and in the form of spray to the 
patches of thrush. 

Administration. — Dose, 5j, three times a day in solution. Topi- 
cally, 5i to water fgj. 

Sodii Bisulphis [Sodium Bisulphite) (NaHS0 3 ) occurs in opaque, 
prismatic crystals or a crystalline or granular powder, slowly oxidizing 
and losing sulphurous acid on exposure to air, having a faint sulphur- 
ous odor and taste, soluble in 4 parts of cold and 2 parts of boiling 
water. 

Effects and Uses. — It is used as a substitute for sodium sul- 
phite, to which it is preferred because of the greater proportion of sul- 
phurous acid which it contains. 

Administration. — Dose, gr. v-xx, in solution. 

Sodii Hyposulphis [Sodium Hyposulphite) (Na 2 S 2 3 +5H 2 0) is used 
for the same purposes. It occurs in white, tabular crystals, of a pearly 
lustre and sulphurous taste, which are efflorescent, and very soluble 
in water and alcohol and insoluble in ether. 

Effects and Uses. — Locally, it destroys the dermal vegetable 
parasites, as tinea versicolor, and it is feebly antiseptic (1 to 3). 

Administration. — Dose, gr. x-xx, three times a day, in solution, 
and for external use, 5j dissolved in water foj, or in ointment. It is 
harmless and non-irritating. 






ANTISEPTICS AND ANTIPYRETICS. 505 

The Sulphides appear to possess the power of checking the for- 
mation of pus. On this ground they are highly lauded in boils, 
abscesses, carbuncles, etc., by Dr. Ringer. 

Calx Suiphurata [Sulphurated Lime), often misnamed calcium sul- 
phide, consists chiefly of a mixture of calcium sulphide and calcium 
sulphate in varying proportions, but containing not less than 60 per 
cent, of calcium monosulphide and some carbon. It is recommended 
to check the formation of pus, in doses of gr. to every hour. 

ACIDUM BORICUM-BORIC ACID (BORACIC ACID). 

Source, Preparation and Properties. — Boric or Boracic Acid 
(H 3 B0 3 ) exists in nature in volcanic regions, notably in Tuscany. The 
supply to the United States is now derived almost exclusively from 
Borax Lake in California, about one hundred miles north of San Fran- 
cisco. Boric acid is obtained in transparent six-sided crystalline 
plates, unctuous to the touch, odorless, slightly bitter, soluble in cold 
water, more so in alcohol and very soluble in boiling water. 

Incompatibles. — With the carbonates and bicarbonates, carbonic 
acid is liberated ; with the alkaline, earthy and metallic bases, borates 
are formed. 

Physiological Effects. — Boric acid is a mild (1 : 143) antiseptic 
deodorant, possessing the power to arrest fermentation. Either in 
solution or powder it is antipyretic and checks the fetor of perspira- 
tion. Neumann found by experiments on dogs, verified on rabbits 
and young pigs, that boric acid caused a decided fall in the tempera- 
ture of the body, while large doses produced diarrhoea and vomiting. 
Three per cent, solutions injected into the serous cavities caused no 
inflammation, but when large amounts were injected the animal died 
from paralysis of the motor-nerves and muscles.* 

According to J. Forster,t boric acid augments the amount of 
nitrogen and of solid matter excreted by the faeces, the increase being 
in direct proportion to the amount of the drug ingested. As small a 
dose as gr. vij daily will produce these effects. 

Toxicology. — Mododewkow reports two fatal cases of poisoning 
with boracic acid. In one case a pleuritic cavity and in the other a 
lumbar abscess was washed out with a five per cent, solution of the 

* N. Y. Med. yotcrn., Jan. 27th, 1863, quoted from Lancet. 
f Dingl's Polytechnik Journ., No. CCLI, p. 170. 



506 MATERIA MEDICA AND THERAPEUTICS. 

acid, some of which remained in both cases. The symptoms were 
persistent vomiting, hiccough, erythema beginning on the face, 
slight temporary rise of temperature, diminished cardiac power ending 
in paralysis. He suggests morphine and stimulants in like cases.* 

Medicinal Uses. — This medicament is rarely used internally, 
though Perez f recommends the internal use of boracic acid (gr. x, 
omn. trihor.) to prevent the formation of ammoniacal urine in the 
bladder in cases of chronic cystitis ; and as it is said to pass through the 
kidneys unchanged, it is recommended as an antiseptic in pyelonephritis. 

External Uses. — Boric acid is employed topically as an antisep- 
tic in the treatment of wounds, burns, ulcers, abscesses, phlegmonous 
erysipelas, acute eczema, etc. In these affections a saturated aqueous 
solution may be applied on sterilized cotton or gauze ; in abscess after 
evacuation it should be injected into the cavity, gr. x-xx to water Fgj; 
in eczema the parts should be first cleaned. A saturated solution is a 
good deodorizing application to correct fetor of the feet, and hyperi- 
drosis. It has also been used with advantage in inflammation of the 
mucous membranes, as aphthce, parasitic stomatitis (thrush), gingivitis, 
etc., in the form of a gargle dissolved in water and glycerin. In thrush 
the parasitic patches should be first cleansed. Da Costa considers boric 
acid second only to thymol in the local treatment of diphtheria applied 
as a lotion. It may be advantageously introduced into the external 
auditory meatus in otorrhcea attended with suppuration. The parts 
should first be cleansed with tepid water, then dried, and the acid 
introduced by insufflation and retained by a cotton-plug for two or 
three days. The same method of treatment is applicable to myringitis. 
Boric acid upon a tampon is used by H. A. Slocum successfully in pro- 
fuse leucorrhoza, the plug being retained two days in the vagina, and the 
same plan is applicable to the treatment of 'vaginitis. It has been applied 
with advantage in inflammation of the conjunctiva (gr. v-x to aq. 
f.5j and mucilage of sassafras pith, f5j ; or Boric acid gr. xxx, borax 
gr. x and water f$j). Used as an injection, it appears to shorten the 
duration of gonorrhoea. Made into an ointment with vaseline or cerate 
(gr. x-xx to Sj) it is an excellent antiseptic dressing for wounds. This 
form may be applied to the eye- lids in blepharitis, and to fissure of the 
nipple. 

Administration. — Dose, gr. v-x, in capsule. A 5 per cent, soap 
can be had in the shops. 

* Wratch, No. 31, 1881. f Lancet, July, 1884, p. 133. 






ANTISEPTICS AND ANTIPYRETICS. 507 

Glyceritum Boroglycerini (Glycerite of Boroglyceriti) is made by 
heating 310 parts of finely powdered boric acid with enough glycerin 
to make 1000 parts, and constantly stirring. When reduced to 500 
parts, 500 more parts of glycerin are added and the result transferred 
to a suitable vessel. This preparation has the advantage of presenting 
the properties of boric acid in liquid form. 

SODII BORAS— SODIUM BORATE. 

Source, Preparation and Properties. — Sodium Borate or Borax 
occurs as a native product in several localities, the most important of 
which for a long time was Thibet, in Asia ; it is also made artificially 
by the direct combination of native boric acid with soda. Borax 
(Na 2 B 4 7 +ioH 2 0) occurs in the form of hexahedral prismatic crystals, 
terminated by triangular pyramids, of a sweetish alkaline taste and an 
alkaline reaction. It is wholly soluble in water, slowly effloresces, and 
possesses the property of rendering cream of tartar very soluble in water. 

Incompatibles. — The mineral and vegetable acids decompose 
borax. With morphine and cocaine salts a precipitate goes down. 

Effects and Uses. — Locally, its action is similar to that of boric 
acid, though feebler. It has no germicidal power. Borax is a mild 
refrigerant and diuretic, and has emmenagogue virtues attributed to it. 

Borax is occasionally of service in cases of epilepsy which do not 
tolerate the bromides or are not benefited by them. It has been given 
in infantile diarrhoea as an enema, and is used topically in cutaneous 
affections (5j to water Oj as a wash m pruritics and acne punctata). It 
is useful as a detergent in aphthous affections of the mouth in chil- 
dren, mixed with an equal quantity of sugar, or dissolved in water it 
makes a cleansing mouth-wash in fetor of the breath ; or as a spray to 
the patches of thrush. Borax gr. ij-v, with a little glycerin, in warm 
water an ounce is serviceable as a douche in chro7iic nasal catarrh. 
Five grains to aq. f Si is used in conjunctivitis. 

Borax lozenges slowly dissolved in the mouth will often cure 
acute hoarseness. The following is a useful solution for the throat in 
diphtheria, being free from toxic influence, ]^ Borax and boric acid, 5ij ; 
chlorate of potash, 5j ; glycerin, f§iv ; hot water, Oj. M. S. — Irrigate 
the fauces with a large syringe having a strong jet. Glycerite of sodium 
borate may be made by rubbing up sodium borate §ij in glycerin Oss ; 
honey of sodium borate may be made by mixing 5j with clarified 
honey, f §j. These preparations are used chiefly as applications to the 
mouth and throat as in pharyngitis and gingivitis. 



508 MATERIA MEDICA AND THERAPEUTICS. 

Administration. — Dose, gr. v-xxx in water. A ioper cent soap 
can be had. 

DERIVATIVES OF THE ORGANIC RADICAL PHENYL. 

The eager search after a remedy which will replace quinine, has 
within the last few years, led to the discovery of medicinal qualities, 
hitherto undreamed of, in various chemical substances, particularly 
with regard to certain members of the aromatic series of the carbon 
compounds. While the remedies heretofore discussed under the head 
of antiseptics are chiefly used topically for their action as protoplasmic 
poisons, the group about to be studied are used internally for their 
antipyretic properties, and though most of them are also antiseptic, 
yet the latter action appears to be readily modified by slight changes 
in certain members of the group. Thus, while salicylic acid is anti- 
septic, its salts do not possess this property, and its isomers — meta- 
and para-oxybenzoic acids — have no such power. 

As some knowledge of their chemical constitution is essential to 
the proper understanding of the relations existing between members 
of this group, a few remarks bearing on this subject will not be out of 
place here. 

CHEMISTRY OF PHENYL. 

Phenyl, the organic radical of this group, consists of carbon 6 
atoms united with hydrogen 5 atoms, the elements being arranged, 
according to the theory of Kekule, on which alone is it possible to 
explain the formation of its derivatives, in such a manner that the C. 
elements are united in a closed chain, exchanging with each other 
alternately one and two valences, and as C. is a tetrad, each with one 
exception, which is unsatisfied, is likewise joined to the corresponding 
element H. ; thus — 

H C H 

C6 2C 

I II 

C5 3C 

/%4/ \ 

H C H 

H 
(Phenyl.) 

Should the unsatisfied atom of C. become saturated with H v phenvl 
hydride, benzine or benzol (C 6 H 6 ), is formed. The atoms of H. in 



ANTISEPTICS AND ANTIPYRETICS. 509 

phenyl hydride may be displaced by other univalent elements or 
radicals and substitution compounds constructed : thus should one 
atom of H. be displaced by hydroxy 1 (HO), phenol or carbolic acid 
(C 6 H 5 HO) is produced; should nitroxyl (N0 2 ) displace an H. atom 
of phenyl hydride, nitro-benzine (C 6 H 5 N0 2 ) results; if amidogen (NH 2 ) 
replace an H. atom, aniline (C 6 H 5 NH 2 ) is formed, and if carboxyl 
(COHO) take the place of H., the product is benzoic acid (C 6 H 5 
CO.OH). 

Di-derivatives containing two atoms of the same element or 
radical, are capable of three isomeric modifications according as the 
replaced H. atoms are those numbered 1.2. or 1.3. or 1.4. in the above 
graphic formula, which isomers take the prefix ortho- or -meta- or para- 
to distinguish them; thus, should hydroxyl displace 2H. atoms in 
phenyl hydride, one of 3 compounds may result — ortho-oxyphenol 
[pyrocatechin), meta-oxyphenol (resorcin), or para-oxyphenol {Jiydro- 
quinone), all of which have the common formula C 6 H 4 (HO) 2 ; or 
should hydroxyl and carboxyl be the replacing radicals, ortho- 
benzoic acid (salicylic acid), meta- or para-benzoic acid may result, 
the formula for each of which is the same — C 6 H 4 HO.COOH. The 
carbon chains of the phenyl hydride group may join with similar 
chains, thus — 

H H 
H C C H 

c c c 

I II I 

c c c 

/ \ / \ // \ 

H C C H 

& k 

(Naphthaline.) 

giving rise to an homologous series, benzine (C 6 H C ) being a single 
link, 2 links united forming naphthaline (C 10 H 8 ), 3 links anthracene 
(C 14 H 10 ), etc. 

The carbon atoms of phenyl hydride may be replaced by other 
elements ; thus, if the triad N. take the place of a C. atom in the 
chain, pyridine (QH 5 N) results. The carbon chains of the benzine 
and pyridine groups may unite with the production of chinoline 
(C 9 H r N), 



H N— H 


1 / 
H C N 


H 


c c c 


1 II 1 
c c c 


H C C H H 


k ^ 


H 



510 MATER/A MEDICA AND THERAPEUTICS. 

H 

H C N H 
\ //\ /% / 

c c c 

I II ! 
c c c 

/ ■ % / \ / X 

H C C H 

I I 

H H 

(Chinoline.) • (Chinocine or Quinocine.) 

or by a modification in the arrangement of valences of the pyridine 
link in chinoline, it is enabled to unite with more H. and N., forming 
chinocine or quinocine (C 9 H 10 N 2 ), and "from these are obtained several 
important salts as kairin (oxyethyl-chinoline hydride hydrochlo- 
rate), thallin (tetrahydroparamethyloxychinoline) and antipyrine (dime- 
thyloxychinocine). 

Phenyl hydride, benzine or benzol is only of interest in medicine 
from a toxicological point, several cases of poisoning from it having 
been reported,* and from the fact as shown by Filehne,f that its deri- 
vatives, benzyl-tropine, benzyl-quinine, etc., are local anaesthetics of 
considerable power. 

ACIDUM CARBOLICUM-CARBOLIC ACID (PHENOL.) 

Source. — This substance, termed also phenol, phenic acid, or 
phenyl hydrate, is a product of the distillation of coal-tar oil. 

Preparation. — Crude Carbolic Acid {Acidum Carbolicum Cruduni) 
is made by treating the impure coal-tar of commerce with a saturated 
solution of potash, when it is resolved, on the addition of water, into a 
light oil and a heavier alkaline liquid ; the latter is separated and neu- 
tralized with hydrochloric acid, and the impure carbolic acid, which is 
disengaged, is afterward distilled from dried calcium, to remove water, 
when upon exposing the distillate to a low temperature, carbolic acid 
congeals in the form of a colorless crystalline mass. Recently a pure 
synthetic phenol has been placed on the market. 

Chemistry. — In its pure state (the acidum carbolicum of the U. S. 
P.) it is solid at ordinary temperatures, crystallizing in long rhom- 
boidal needles, white or colorless, of a peculiar empyreumatic odor 
like unto (but not identical with) that of creosote, and a burning taste ; 

* Annales (P Hygiene, 1883, p. 426, MM. Neumann et Pabst. 
| Berlin Klin. Wochensch., No. 7, 1 88 7. 



ANTISEPTICS AND ANTIPYRETICS. 511 

if even slightly impure, it has a reddish color, or will acquire it on ex- 
posure. It combines with salifiable bases, being faintly acid to litmus 
paper, and is chemically phenyl hydrate (C 6 H 5 HO). Its sp. gr. is 
1.065 ; it deliquesces readily and assumes the liquid state in the pres- 
ence of a little water, without dissolving in it. Its vapor is inflam- 
mable. 

Properties. — When quite pure it melts at 160 F., forming an 
oily-looking, colorless liquid, which boils at 359 F. It is soluble in 
about 15 parts of water, and very soluble in alcohol, ether, acetic acid, 
glycerin, and in the fixed and volatile oils. 

TESTS.^Carbolic acid may be recognized by the following tests : 
"ist, by its peculiar smell ; 2d, by the formation of yellow picric acid, 
with nitric acid of 36 B. ; 3d, by the production of a blue or green 
color when treated with a small quantity of ammonium hydrate and a 
trace of a solution of a hypochlorite " (Salkowski's test) ; "4th, by a 
lilac color produced on the addition of a small quantity of ferric sul- 
phate; 5th, by a yellowish-white precipitate with bromine water" 
(Witthaus*). 

The last three tests are very delicate. 6th. The most delicate 
test is that suggested by Plugge : " When a liquid containing carbolic 
acid is boiled with a little solution of mercurous nitrate containing a 
trace of nitrous acid, a reduction of the mercurous salt takes place 
and the liquid becomes of an intensely red-color." This test is said to 
detect 1 part of carbolic acid in 200,000. Carbolic acid in solution 
coagulates albumen and precipitates nitro -cellulose from collodion, 
which distinguishes it from creosote. 

Incompatibles. — With the alkalies and alkaline earths, carbolates 
are formed ; mixed with bromine a white precipitate goes down. It is 
also incompatible with antipyrine, collodion and the metallic salts. 

Aids. — Creosote and the phenol derivatives. 

Physiological Effects. — Carbolic acid is a protoplasmic poison, 
destructive to all forms of life, whether vegetable or animal. Watery 
solutions of this agent, I to 100, destroy the anthrax bacilli in two 
minutes, while 1 to 30 retards the development of spores and kills all 
matured organisms. Oleaginous and alcoholic solutions are less 
effective than aqueous solutions. Locally. — When applied to the skin 
it produces a white superficial eschar, due to the coagulation of the 
albumen of the tissues, becoming brownish. Weak solutions are 

* General Med. Chemistry. By R. A. Witthaus, A. M., M. D. 



512 MATERIA MEDICA AND THERAPEUTICS. 

cooling and analgesic ; strong, actively caustic. When applied in a 
concentrated form it causes very great local anaesthesia, extending in- 
ward for some depth to the tissues with which the acid has not come 
in contact. 

Internally. — The taste of carbolic acid is acrid and burning ; in 
dilute solution sweetish with an after-burning taste. Carbolic acid in 
medicinal doses produces a rather cooling, sedative effect upon the 
stomach, and it probably enters the blood as an alkaline carbonate. 
Nervous system : after poisonous doses have been given to animals, 
there is paralysis of the posterior extremities, extending to the anterior, 
and finally reflex tetanic convulsions. In man a poisonous quantity 
produces vertigo, contracted pupils, and stupor with sometimes tremors, 
never, however, amounting to convulsions, as in the lower animals. 
The convulsions are probably of spinal origin — certainly not peri- 
pheral. The reflex activity is at first increased, then abolished. The 
nerves and muscles are not paralyzed, but after death they are found 
to be more readily exhausted than normal. Circulation : the heart is 
at first depressed, afterwards accelerated (caused by stimulation and 
exhaustion of the vagi). In slow cases of poisoning, death is produced 
by diastolic arrest. The arterial pressure is reduced on account of 
the paralysis of the vaso-motor centre of the cord. Dr. Prudden* has 
shown that in strong solution it paralyzes, while in weak solution it 
renders sluggish the movements of the white corpuscles in frogs. 
Respiration is affected early in the poisoning, the movements being 
much increased in frequency, but very shallow ; this increase is due to 
stimulation partly of the peripheral vagi and partly of the respiratory 
centre (Salkowski). Temperature is somewhat reduced. Elimination 
takes place by all the secretions, especially by the urine, saliva and 
breath. When a small amount only is taken, it is probably all 
excreted as an alkaline carbolate; but when the amount is larger, a 
portion is oxidized in the system and escapes under different forms, 
especially as oxalic acid in the urine. These products of oxidation 
generally color the urine dark brown or black, and as this is one of 
the first signs of poisoning, the urine should always be watched when 
carbolic acid is being administered or when it is applied to a large 
surface. 

Toxicology. — Andersonf reports a case in which 5j of the pure 



* Amer. Journ. Med. Set., Jan., 1S81. 
f The Lancet, Jan., 1869, P- x 79« 



ANTISEPTICS AND ANTIPYRETICS. 513 

acid killed an adult in twelve hours, with symptoms of acute gastritis; 
and Hearder* one in which a man died in thirty minutes after swal- 
lowing oj. The external application, too, of carbolic acid has de- 
stroyed life. Drops 6-7 have caused dangerous symptoms. Post- 
mortem appearances: after death from a concentrated solution of the 
acid, hard, white, dry spots surrounded by a circle of inflammation 
are found on all the mucous membranes, particularly visible about the 
lips and fauces, with which the acid has come in contact, even as far 
down as the intestines in some instances. All the viscera are filled with 
dark, imperfectly-coagulated blood, and sometimes there is fatty 
degeneration of the liver and kidneys. 

Antidotes. — As a chemical antidote in cases of poisoning a 
saturated solution of calcium saccharate has been recommended. To 
evacuate the stomach the stomach-pump should be used, since the 
benumbing influence of the poison hinders the action of emetics. 
Demulcents should be given, but not oils, as it is soluble in them. 
By forming salts with the alkalies its poisonous action is to a certain 
extent neutralized, hence their exhibition is called for. Atropine is 
the physiological antagonist of carbolic acid ; enough should be given 
to counteract the depressing effect of the acid upon the respiration and 
circulation, and diluents should be freely administered to aid in its 
elimination (A. C. Post). It is a common and rapidly fatal poison. 

Medicinal Uses. — Carbolic acid is prescribed internally to check 
vomiting where the stomach is irritable and nausea a constant symptom, 
the dose to be small and taken every 3 or 4 hours ; as an antifermen- 
tative in eructations and pyrosis ; as a local intestinal astringent in 
chronic diarrhoea ; to destroy the germs of sarcina ventriculi ; and as 
an anthelmintic against ascarides and taenia solium. It has also been 
given internally with some success combined with iodine in malarial 
cachexia. 

By Injection. — Deep-seated injections (see Appendix) into the 
tissues of a two per cent, solution of carbolic acid, as recommended by 
Hiiter, have been practised with success in erysipelas at the margin of 
the spreading inflammation (Aufrecht), abscesses, etc., and are thrown 
into the cavity of joints in synovitis, and into bur see in ganglion, etc. 
Extraordinary care must be taken not to inject the acid into a blood- 
vessel. 

Dr. R. J. Levis has injected pure carbolic acid (the crystals lique- 

* Brit. Med. Jour., May, 1873, p. 584. 
33 



514 MATERIA MEDICA AND THERAPEUTICS. 

fled by heat) 5ss-j into the sac of the tunica vaginalis after evacuating 
its contents, for the radical cure of hydrocele. This treatment is fol- 
lowed at the Out- Patient Surgical Department of the Jefferson College 
Hospital with almost unvarying success. Dr. S. W. Gross* has col- 
lected 90 cases of hydrocele treated by the carbolic-acid method, all 
of which were successful, though suppuration ensued in three. It is 
occasionally injected into hemorrhoidal tumors for the cure of piles, but 
it is not altogether a safe remedy ; and by enemata into the rectum 
(gtt. vj to water Oj), against thread-worms. 

External Uses. — As an external application its uses are still more 
important. In the concentrated form it is employed as a cauterant in 
condylomata, gangrene, chancroids, lupus, the bites of rabies, etc., and 
to produce local anaesthesia for minor surgical operations as the open- 
ing of abscesses, felons, etc., and in various forms of dilution (glycerin, 
1, carbolic acid, 2 or 3) in cutaneous eruptions of parisitic origin as 
tinea circinata, t. tonsurans, t. capitis, favus, scabies, etc. ; to the pustules of 
acne in full strength ; in the form of ointment as an antipruritic remedy 
to pruritus ani and other parts ; to allay the itching of acute eczema and 
prickly heat, and the eruption of chicken pox, applied as a lotion or with 
vaseline; as an application in urticaria (Tftx to glycerin f 5j), and in 
erythema ; to relieve the pain and itching of chilblain; as a wash to 
cleanse the parts in psoriasis and phthiriasis. In epistaxis carbolic acid 
in olive-oil (1ft v-x to f oj) passed through the nostrils on cotton will 
often stop obstinate bleeding. For swabbing the throat and fauces in 
diphtheria the following is advised : 1^ Acid carbolici, tftxv ; tinct. ferri 
chloridi, f5ijss ; glycerini et aquae, aa f§j. Dr. E. B. Bronson f recom- 
mends the following to relieve pruritus : 1^ Acid carbolici, 5i-ij ; liq. 
potassae, f 5j ; ol. lini, f§i. M. S. — Shake before applying ; ol. of berga- 
mot, gtt. i-ij, may be added. 

Carbolic acid spray is applied in chronic nasal catarrh, hay-fever ; 
chronic laryngitis, zvhooping-cough, phthisis, gangrene of the lungs, etc., 
with a view of destroying germs, stimulating the mucous membrane to 
healthy action and correcting the fetor. Burneo Yeo J advises the 
following procedure in whooping-cough : The child should be confined 
to a moderately-sized bed-room containing an open fire-place, and 
from time to time a teaspoonful or two of carbolic acid should be 

* Med. Times, April, 18S8, p. 384. 

f Med. Record, N. Y., Oct. 7, 1893. 

% Manual of Med. Treat, etc., 11., p. 578. 



ANTISEPTICS AND ANTIPYRETICS. 515 

vaporized in an iron spoon, and a steam carbolic spray kept going near 
the bed. 

To check the fetor of the breath arising from carious teeth, and as 
a mouth-wash in gingivitis it is of service. Carbolic acid is much em- 
ployed in the form of aqueous solution as a dressing to foul ulcers, 
opened abscesses, sinuses, fistulce, carbuncle, buboes, etc., to compound 
fractures, to bums and scalds, to suppurating surfaces with a view to 
checking this process and the prevention of pycemia, and for its use in 
coagulating albumen as an haemostatic agent in hemorrhage. 

In aural therapeutics carbolic solution is em ployed to cleanse and 
disinfect the auditory canal before the introduction of powders as in 
otorrhoea and myringitis. A minute portion applied to the hollow of a 
carious tooth will often alleviate toothache. It is one of the local rem- 
edies used in endometritis, and may be mixed in glycerin and applied 
upon cotton within the uterus. As a deodorizing-antiseptic agent it 
has a wide range of usefulness ; to this end it may be injected in dilu- 
tion into the vagina in female gonorrhoea, and as a lotion to keep clean 
the glans penis in balanitis and chancres and chancroids, and in the 
form of spray to purify the nostrils in ozcena, and chro7iic nasal catarrh. 
Under the belief that carbolic acid destroys the organic floating germs 
which produce inflammation and suppuration upon wounded surfaces, 
washings and dressings with solutions of this acid (i part to 40 parts 
of water) are employed, as first suggested by Sir J. Lister, of Edin- 
burgh. It is also a most valuable disinfectant. A weak carbolic solu- 
tion is used to place instruments in during an operation, but it dulls 
their edge. 

Administration. — The dose internally is gr. j-ij, given in cap- 
sules or pills (made with powdered glycyrrhiza), or, if liquefied by heat, 
gtt. i-j, in sweetened water and glycerin. A solution of carbolic acid, 
98 parts, in glycerin, 2 parts, is kept in the shops for dispensing. A 5 
per cent, soap may be obtained. For topical purposes it may be dis- 
solved in water, 1 to 10, 20 or 50. For disinfectant purposes, the crude 
■ carbolic acid (acidum carbolicum crudum) (which contains from 70 to 90 
per cent, of phenol and cresol jointly, with impurities derived from 
coal-tar) answers" very well. Ointment of carbolic acid {iinguentum 
acidi carbolici) contains 5 percent, of carbolic acid in ointment. Glyce- 
rite of carbolic acid (glyceritum acidi carbolici) consists of carbolic acid 
2 parts to glycerin 8 parts; for external use. The U. S. P. directs 
carbolic acid to be kept in dark-amber colored well-stoppered vials. 

Sodii sulphocarbolas {Sodium sidphocarbolate) (NaS0 3 C 6 H 4 (OH)-f 



516 MATERIA MEDIC A AND THERAPEUTICS. 

2H 2 0) is a colorless, transparent salt occurring in rhombic prisms, 
permanent in the air, soluble in about 5 parts of water, and also in gly- 
cerin and alcohol. Sodium sulplwcarbolate is a good remedy for flatu- 
lence ; dose, gr. x-xv, in powders. Zinc sulphocarbolate gr. xxx, in 
water and hydrogen peroxide, of each f§ij, is a favorite injection in 
gonorrhoea. 

Potassium, magnesium and calcium sulphocarbolates have also 
been employed ; they may be given as antiseptics in cholera and zymotic 
diseases generally. They are recommended as excellent topical appli- 
cations to inflamed mucous membranes, and good results have attended 
their use in acute tonsillitis, aphtha of children, acute nasal catarrh and 
gonorrhoea. 

CREOSOTUM— CREOSOTE. 

Source and Preparation. — Creosote is a complex substance, a 
mixture of phenols, chiefly guaiacol and creosol, obtained from wood-tar 
by dry distillation, or from crude pyroligneous acid ; the best is made 
from beechwood-tar, derived from the Fagus sylvatica. 

Constituents and Properties. — It contains phenol (C 6 H 5 HO), 
cresol (C 6 H 4 (CH 3 )HO), creosol (C 8 H 10 O 2 ), and guaiacol, besides other 
substances obtained from wood-tar. When pure it is a colorless, oleagi- 
nous liquid, of a burning taste and a penetrating, disagreeable, character- 
istic odor, like that of smoked meat. Its sp. gr, (U. S. P.) is 1.035- 
1.085, but when pure is 1.080. After exposure to light for a long 
period it becomes wine-yellow ; if it turn red, it is not fit for medicinal 
use. It mixes but sparingly with water (1 to 150); and it is soluble, 
in all proportions, in alcohol, ether, naphtha, and glacial acetic acid. 

Tests. — Crude phenol is often substituted for creosote; the latter 
may be distinguished by its insolubility in commercial glycerin ; by 
not precipitating nitro-cellulose from collodion when mixed with it ; by 
giving a green color with ferric chloride and alcohol (phenol gives a 
brown color) and by yielding a green color passing to brown with 
ferric chloride and ammonium hydrate (phenol giving a violet color) 
(Witthaus). 

Incompatibles. — Strong sulphuric and nitric acids decompose it; 
and it reduces some of the metallic salts as silver nitrate. 

Aids. — Phenol and its derivatives. 

Physiological Effects. — Locally, creosote is caustic, antipruritic, 
analgesic and astringent; and it possesses well defined antiseptic and 
germicidal powers. The taste of creosote is burning and caustic. It 
has many properties in common with carbolic acid. A remarkable 



ANTISEPTICS AND ANTIPYRETICS. 517 

property of creosote is its power of preserving meat, whence its name 
(from ^oiac, flesh, and aco^aj, I save). It is eliminated by the bronchial 
mucous membrane (which it stimulates as it passes out, and hence is 
a good expectorant), by the kidneys, the latter carrying off % of the 
dose ; of guaiacol y& leaves by the kidneys.* In large doses it is an 
acro-narcotic poison, resembling carbolic acid, but with more marked 
nervous symptoms. 

Toxicology. — In cases of poisoning from creosote the same treat- 
ment is to be resorted to as in poisoning by carbolic acid. 

Medicinal Uses. — In small doses it is styptic and astringent, as it 
coagulates albumen, and, though not very nearly allied to the vege- 
table astringent articles that contain tannic acid, it is, perhaps more 
generally administered for its astringent than for any other properties. 
It is very efficacious in allaying vomiting, eructations and gastric 
irritability, as an anti-fermentative in pyrosis, and it has been exhibited 
for its astringent virtues with good effects in chronic diarrhoea, and as a 
nervine in epilepsy, hysteria, neuralgia, etc. In the treatment of phthisis 
the concensus of opinion is in favor of the good effects of creosote — the 
drug, perhaps, destroying the tubercle bacillus (Guttman). This, how- 
ever, is denied by Whittaker.f Jaccoud believes that it exerts a cura- 
tive influence on the tubercular lesions. Burney Yeo j states that it 
diminishes expectoration, lessening its purulency and the tendency to 
haemorrhage. In a series of ioo cases Osier § noted that its chief 
action was to lessen cough and expectoration, without influencing the 
progress of the disease. Guaiacol is used for the same purpose. 

Topically, it is applied, in various degrees of dilution, to indolent, 
sloughing and foul ulcers. In the concentrated form it is a good 
styptic in capillary hemorrhages, and it is applied with effect to the 
hollows of carious teeth, for the removal of the pain of toothache. In 
dermal therapy it is chiefly prescribed for its antipruritic virtues, as in 
chronic eczema, gr. viij-x to the ounce of ointment or in solution. 

Administration. — Dose, internally, TTtj-iij, frequently repeated, 
in pill or capsule. For hypodermic solution of, see Appendix. 

For topical application, from gtt. ij-vj, or more, may be added to 
f Sj of distilled water. 



* Bull. Gen. de Therap., 1892, p. 229. L. Imlost. 

f Therap. Gazette, July 15, 1893. 

\ Manual of Medical Treat., etc., II, p. 23. 

\ Practice of Medicine, p. 254, 1892. 



518 MATERIA MEDICA AND THERAPEUTICS. 

Aqua Creosoti [Creosote-Water] (i part to distilled water 99 parts). 
— It may be used topically as a slightly stimulating lotion, or mixed 
with poultices to correct fetor. Internally, it is a convenient form of 
administration. Dose, f5j-jv. 

Guaiacol* (not official) is a colorless liquid of a strong aromatic 
odor, soluble in alcohol and ether, but not in water, constituting 
60 to 90 per cent, of creosote. It forms derivatives with C0 2 (guaiacol 
carbonate) ; salicylic acid (guaiacol salicylate, a body like salol), and 
others. The chief effect of guaiacol is the decided fall in temperature 
caused by it when painted on the skin, which was first called attention 
to by Sciolla. From gtt. 30-50 are applied, the parts being first 
washed, once or twice daily, when a fall of fever-temperature 1-3 
degrees takes place in from 1-4 hours, the reduction being invariably 
accompanied by profuse diaphoresis, and often depression and chilli- 
ness. After application it appears in the urine in 15 minutes. It is 
applied in typhoid fever, pneumojiia and influenza ; but its depressing 
action must be borne in mind. Internally, gtt. iij-v, t. d., are given with 
benefit (in capsule) in phthisis, its action being that of creosote. 

Administration. — As a local antipyretic, gtt. 30-50 may be 
rubbed on the skin. Drops 5-10 may be inhaled from hot water. 
Guaiacol carbonate is dispensed as a substitute for creosote, gr. vi-x, 
gradually increased. Of Guaiacol, Tfljij-v, in capsules. 

The Cresolsf (not official) are homologous univalent phenols 
obtained by the fractional distillation of coal-tar, in which one atom of 
H in carbolic acid is replaced by a methyl group CH 3 . They have 
the odor of tar, form emulsions with water, and possess powerful 
germicidal properties ; the meta being the most active, but being 
insoluble are administered in the form of creolin, a brown alkaline 
liquid, of characteristic odor, soluble in alcohol and forming a turbid 
mixture with water. Pearson's creolin is said to be a mixture of 
cresols in resins, soap and certain hydrocarbons. It is relatively non- 
toxic, superior in germicidal power to carbolic acid, and free from 
irritating properties. It is given in capsules of TfiVv; and topically in 
solution 2 per cent., or rubbed up with lanolin. 

Tricresol (not official) is a mixture of the ortho-meta- and para- 
cresols ; a one per cent, solution kills the pus microbes in 30 seconds. 



* N. Y. Med. J., Apl. 14, 1894; Brit. Med. J., July 7, 1894; Lyon Medicate, Apl- 
1, 1894. 

| Helbing, Mod. Mat. Med., 1894. 



ANTISEPTICS AND ANTIPYRETICS. 519 

Tricresol-water(i to 500 or 1000) is non-irritating, and maybe used to 
preserve collyria.* 

Lysolf (not official) is that portion of coal-tar which boils between 
190 and 200 C, dissolved in fat and saponified with the addition of 
alcohol. It contains 50 per cent, of the cresols, forms with water a 
clear, saponaceous, frothing liquid ; it also mixes with alcohol and 
glycerin. Its effects are similar to carbolic acid, than which it is 5 
times stronger and 8 times less poisonous. It is employed in surgery, 
gynaecology and dermatology, and for the immersion of instruments. 

Nitro-benzine is an important agent in the aniline industries, 
being used in the manufacture of the latter for commercial purposes. 
It is not employed in medicine, but is interesting on account of the 
numerous cases of poisoning which have occurred from its use in per- 
fumery (in which it is known as the " Essence of Mirbane "), and to 
impart the flavor and smell of bitter almonds to articles of food or 
beverages. It has also been taken by mistake for a liquenr.% The 
proper treatment of poisoning by this substance is the prompt evacua- 
tion of the contents of the stomach if it has been swallowed, artificial 
respiration, and blood-letting followed by transfusion. 

Benzinum {Benzin). 

Preparation and Properties. — This is obtained by the purifica- 
tion of the "distillate from American petroleum." It is a colorless 
volatile liquid, of characteristic odor, and neutral reaction. Its vapor 
is inflammable. 

Chemical Constituents. — Hydrocarbons of the marsh-gas series, 
pentane (C 5 H 12 ), and hexane (C 6 H 14 ). 

Effects and Uses. — Its vapor is said to destroy insects. Inter- 
nally it is described as causing a kind of intoxication followed by coma. 
Its toxic action resembles that of nitro-benzine. It has been employed 
topically only against scabies, tinea and favus. 

Aniline is used especially in the manufacture of brilliant dyes. 
Numerous cases of poisoning are on record from the ingestion of con- 
fectionery, etc., colored by this means. 

The various aniline colors are used in medicine as reagents in 
staining bacilli for microscopical examination. It is also interesting 
as being the base of aniline acetate, from which antifebrin, one of the 
latest and most powerful antipyretics, is obtained. 

* Therap. Gaz., July 16, 1894. 

f Notes on New Remedies, N. Y., Oct., 1891 ; and Aug., 1893. 
% Deutsche milit,-Zeitung y II, 1873. 



520 MATERIA MEDIC A AND THERAPEUTICS. 

ACETANILIDUM-ACETANIL1D. 

Preparation and Chemistry. — Acetanilid or Antifebrin (C 6 H 5 NH 
QH3O) is a neutral chemical product, prepared by heating aniline 
with crystallizable acetic acid in a special receptacle, distilling the 
product and purifying by successive crystallizations, and consists of 
aniline acetate from which the elements of water have been separated 
by a dialytic action at an elevated temperature (Merck). 

Properties. — It is a very stable compound, resisting the action 
of acids and alkalies at ordinary temperatures, and occurs in the form 
of a white crystalline neutral powder, odorless, and having a not dis- 
agreeable taste, almost insoluble in cold water (1 to 194 parts), but 
soluble in alcohol (5) and ether (18). 

Physiological Effects. — The taste of acetanilid is faintly burn- 
ing. The most important effects of this drug are the rapid lowering 
of febrile temperature and the power which it possesses of moderating 
the activity of the nerve-centres. 

As an antipyretic it is four times more powerful than antipyrine, 
causing a reduction of temperature within an hour after its administra- 
tion, the minimum being attained in from three to five hours, followed 
at first by a slow and then a more rapid rise until the temperature 
reaches the original height, or even a little beyond it, in from three to 
twelve hours.* This action is more marked when the temperature is 
very high,f and when the medicine is so administered that the arti- 
ficial reduction will take place coincidently with the natural subsi- 
dence : thus its effects are greater when given in the morning. More 
or less profuse perspiration occurs during the reduction of the body- 
heat, and the succeeding rise is sometimes preceded by a rigor. 

From extensive and careful experiments with acetanilid, thallin 
and antipyrine, Pasternatzky % concludes that from five to ten minutes 
after taking either of these substances, the internal temperature rises, 
and the heat given off by radiation is increased in direct proportion to 
the elevation of the cutaneous temperature, although the maximum 
elevation is attained earlier than the maximum loss of heat, and that 
the sweating coincides with the latter. During the second hour the 
internal temperature continues to fall, but with more intensity ; the 



* Centralbl. f. Klin. Med., No. 33, p. 1561. Cahn und Hepp. 
| Deutsche Med. Wochensch.^o. 16, 1887. 
\ Vratch., No. 2, p. 21 ; No. 4, p. 70, 1887. 



ANTISEPTICS AND ANTIPYRETICS. 521 

cutaneous temperature gradually subsides, and the loss of heat by 
radiation and the sweating diminish in direct proportion to the decline 
of the latter. Therefore, not only do they lower temperature, but 
they also balance the distribution of caloric in the system. They are 
antipyretic, by restraining nitrogenous metamorphosis, by limiting 
heat-production, and also by regulating the heat-distribution of the 
economy. These effects are only seen in a condition of pyrexia. As 
the temperature falls the pulse becomes slower and stronger and the 
arterial tension is heightened. Acetanilid impairs temporarily the 
oxygen-carrying function of the red corpuscles, by lessening the oxy- 
hemoglobin and forming with it methy-haemoglobin, as is shown by 
the cyanosis which is sometimes observed, but this condition quickly 
passes away as the normal condition of the blood is restored. 

Gastric or intestinal disturbance is of rare occurrence, while renal 
irritation never results, although the amount of urine is sometimes con- 
siderably augmented ; and lastly the elimination of urea is diminished.* 

In decided doses, acetanilid lowers the activity of the reflex centres, 
and reduces the conductivity of the motor and sensory nerves, prob- 
ably to a great extent through its influence on the blood. f An incli- 
nation to sleep accompanies this analgesic action. 

Toxicology. — If given in lethal doses % (gr. v-x per kilo, of 
weight of animal), the effects are manifested primarily upon the con- 
stituents of the blood and then on the nervous system ; afterward 
general prostration with stupor ensues, and the temperature is rapidly 
and progressively lowered. Sensation is first diminished and then 
lost ; the animal sinks into a comatose condition, followed by spas- 
modic convulsions, and dies in from 24 to 36 hours. The heart is at 
first accelerated, then slowed, and the respiratory functions are mark- 
edly and progressively depressed. 

Medicinal Uses. — Acetanilid is chiefly used as an antipyretic 
and anodyne. For the former purpose it used to be more generally 
employed than any other agent of this group, although some ob- 
servers § regard antipyrine as safer, fearing the cyanosis tendency to 
collapse, and severe rigors which occasionally attend the action of ace- 
tanilid. 

* Russ. Meditz., No. 43, 1886, p. 728. A. Berezovski. 

f Comptes Rendus de la Soc. de Biol., Juillet, iieme, 1887. M. Lepine. Rev. Med. 
de la Suisse Romande, Juin, 1887. M. Demieville. 

% Bull. Gen. de Therapy Fev, 28ieme, 1887. Dr. Weill. 

\ Comptes Rendus de VAcad. des Sciences, Avril i8ieme, 1887. Germain See. 



5*22 MATERIA MEDIC A AND THERAPEUTICS. 

In cases of /rzw-temperature, notably typhoid fever, and scarlet 
fever, it may be given in small doses, repeated as required, with ex- 
cellent effect. 

In acute rheumatism it not only reduces the temperature, but also 
is said to act on the joints in as favorable a manner as do the salicy- 
lates. In croupous pneumonia and in chronic catarrhal pneumonia, it 
has been prescribed with advantage early in the disease. 

It is used as an anodyne in the pains of the various nervous 
diseases, especially those of locomotor ataxia ; also in neuralgia, par- 
ticularly of the fifth pair of cranial nerves ; in headaches of various 
kinds not depending on indigestion, and in dysmenorrhoea. 

In epilepsy it diminishes the violence and frequency of the petit 
mal, but does not seem to influence the grand mal. 

Administration. — The dose of acetanilid ranges from gr. iv-viij, 
though much larger quantities have been taken with safety. The 
maximum daily quantity would be about gr. 45 ; children may take 
about gr. y 2 for each year of age, t. d. It is best administered in cap- 
sules or in powder, and it diffuses readily into the blood in spite of its 
insolubility. 

EXALGINE-(METHYLACETANILIDE). 

Preparation, Properties and Chemistry. — Exalgine (not offi- 
cial) from iz, without, and alyoc, pain, discovered by Hoffman in 1874, 
and recently introduced, is obtained by heating methylaniline with 
acetyl chloride and purifying the product by successive crystallization 
in pure alcohol and water. It occurs in long, white, fine crystals, 
tasteless and odorless, slightly soluble in water, but dissolving in 
alcohol pure or diluted. It is, theoretically, of complex structure as 

I IT 

follows : for 2 of the H's of aniline C 6 H 5 N u there are substituted 2 

different molecules, one, acetyl (C 2 H 3 0), the other methyl (CH 3 ), hence 
the formula CH 3 .C 2 H 3 O.C 6 H 5 N, and the name methylacetanilide. 

Incompatibles. — It reduces, dissolved in dilute alcohol, potassium 
permanganate ; with the iodides, iodine is liberated, and liquor potassae, 
a precipitate, is formed ; with salicylic acid a soft paste results, after- 
ward liquefying. 

Aids. — Its analgesic and antipyretic effects are increased by the 
agents of this class, as antipyrine and salol ; also in the first-named 
range by belladonna, opium and cocaine. Insoluble remedies like 
salol and acetanilid may be taken in the same capsule with it. 

Physiological Effects. — Locally, it possesses a feeble and tran- 



ANTISEPTICS AND ANTIPYRETICS. 523 

sitory anaesthetic action, and it benumbs that portion of the tongue to 
which it may be applied. It has but little action on digestion except 
increasing the flow of saliva. Its effects have been carefully investi- 
gated by Gandineau,* who found that in man a dose of gr. jv-vj pro- 
duces no phenomena, except perhaps a slight buzzing within the ears. 
Wnen injected under the skin of mammals, clonic convulsions, accel- 
erated breathing and salivation are produced accompanied by lower- 
ing of temperature. Lethal quantities, about gr. vj per 2j^ lbs. of the 
animal's weight, destroy life by collapse, the blood being found dark- 
colored through reduction of the oxyhemoglobin. Exalgine affects 
profoundly the cerebro-spinal axis, full doses producing trembling, 
anxiety, loss of sensibility, and motor-power, the tactile sense persist- 
ing, until life terminates by respiratory paralysis. The arterial tension 
is generally increased. It is only by the exhibition of a quantity 
sufficient to bring about its full action that benefit is to be derived from 
its use. Caution, however, must be enjoined with this new remedy, 
as lethal effects have been produced with medicinal doses. 

Toxicology. — A woman took gr. xij in half an hour, and com- 
plained only of gastric pain ; twenty-four grains taken in half an hour 
produced giddiness, stupor and sleep. 

Medicinal Uses. — This new medicament, by reason of its pecu- 
liar property of diminishing sensibility, should be adapted to the 
treatment of neuralgia, sciatica, lumbago, and to allay the fugacious 
pains of locomotor ataxia.\ It is not to be understood, however, as 
supplanting the old and well-tried remedies, but rather as a new-comer 
under trial. It has, to a certain extent, been employed with success 
as an analgesic, in cases of neuralgia, migraine and torticollis in the 
dose of gr. j-vj per diem. Lowenthal]; and Moncorvo § report good 
results (the former 35 cases) in chorea treated with exalgine, the 
dose being gr. iij, t. d. 

Administration. — The dose varies from gr. J^-4; or gr. vj-x in 
24 hours. As exalgine is but slightly soluble in water it may be 
administered either in powder or capsule. 



* Bull. Gen. de Therap., 1889, p. 207; also, Lancet, London, vol. ii. i89i,p. 950, 
and 1892, p. 1 173; La Tribune Medicate, Juin 9, 1892; Med. Press and Circular, 1892. 
f Bull. Gen. de Therap., Fevrier, 1890, p. 214. 
% Berliner Klinische Wochen., Feb. 1, 189 1. 
\ Bull. Gen. de Therap., Mai 30, 1891. 



524 MATERIA MEDICA AND THERAPEUTICS. 

ACIDUM BENZOICUM—BENZOIC ACID. 

Preparation and Properties. — Benzoic Acid (HC r H 5 2 ) is ob- 
tained from benzoin by sublimation, or by the action of alkalies ; 
it is also made in Germany from hippuric acid. As obtained by 
sublimation, it occurs in white, soft, feathery hexagonal crystals, of a 
silky lustre, and not pulverulent. It has more or less of the agreeable 
odor of the balsams, and a warm taste, is inflammable, sparingly solu- 
ble in cold water, freely soluble in boiling water, but perfectly soluble 
in alcohol and ether. It is a constituent of the balsams. 

Incompatibles. — With the alkaline salts, as those of potassium 
sodium, etc. 

Aids. — Borax and boric acid. 

Effects and Uses. — Benzoic acid is a local irritant. It restrains 
the growth of the putrefactive bacteria if present in bouillon, in the 
proportion of 1-909 (Miquel). Its taste is warm, acrid and acidulous. 
Internally, it acts on the general system as a stimulant, with a partic- 
ular direction to the mucous surfaces. In large doses it increases 
the action of the circulatory and respiratory apparatus, and is said to 
be a more powerful antipyretic than salicylic acid. It stimulates the 
cutaneous and bronchial secretions, and increases the acidity of the 
urine. In its passage through the system it is partly decomposed, 
passing out with the urine in the form of hippuric and benzoic acids, 
during which it plays the part of a mild antiseptic as well as acidifying 
the urine, hence its value in the treatment of ammoniacal urine, 
pyelonephritis, and in chronic cystitis and irritable bladder, when accom- 
panied by alkalinity and phosphatic deposits. Topically, it is applied 
as a dressing for wounds, idcers, etc., and to prevent animal fats from 
becoming rancid. 

Administration. — Dose, gr. v-xx ; if in pill soap should be the 
excipient, or in capsule ; lozenges, gr. y^ each, are employed in pha- 
ryngitis. 

Sodii Benzoas {Sodium Benzoate) (NaC 7 H 5 2 ). 

Properties. — This is a white amorphous powder, freely soluble 
in water, which effloresces on exposure to the air, and has a faint odor 
of benzoin and a sweetish, astringent taste. 

Effects and Uses. — It has been prescribed as a substitute for 
salicylic acid, being less powerful as an antipyretic, but is a safer 
remedy. 



ANTISEPTICS AND ANTIPYRETICS. 525 

Administration. — From 5j-iij may be given in twenty-four hours, 
in water, or in 5 gr. compressed pills. As a gargle in pharyngitis, gr. 
xx to f Si of water. 

Ammonii Benzoas {Ammonium Benzoate) (NH 4 C 7 H 5 2 ). 

Properties. — This salt occurs in the form of minute, white, 
shining, thin, four-sided laminar crystals, with a slight odor of benzoic 
acid and a bitterish, saline, somewhat balsamic taste and slightly acrid 
but persistent after-taste. It is soluble in water and alcohol, and, 
when heated, sublimates without residue. 

Incompatibles. — It is incompatible with the ferric salts. 

Effects and Uses. — This salt, when taken internally, is probably 
decomposed by the gastric acids, and produces the constitutional 
effects of benzoic acid, for which it may be substituted ; the ammonia 
renders it stimulant and antacid, and acceptable to irritable stomachs. 
It is an excellent remedy for incontinence of urine due to the irritation 
produced by an alkaline condition of that fluid, and is taken with ad- 
vantage in irritable bladder whenever the urine is alkaline and loaded 
with phosphates, and in ammoniacal urine. 

Administration. — Dose, gr. v-xx, in solution. 

resorcinum— resorcin. 

Preparation. — Resorcin, chemically a diatomic phenol, [C 6 H 4 
(OH 2 )], derives its name from having been first obtained from certain 
resins by the action of alkalies, and from bearing some resemblance to 
orcin. 

Properties. — It occurs as shining, tabular, colorless or reddish 
crystals, having a slightly phenol-like odor and a sharp taste, soluble 
in most liquids, especially in water. 

Physiological Effects. — Locally, it is a weak anti-fermentative 
anti-putrefactive and parasiticidal agent, destroying the organisms on 
which these processes depend. It coagulates albumen. The taste of 
resorcin is sharp and afterward pungent. Internally, like other agents 
of this group, resorcin promptly reduces febrile temperature when ad- 
ministered in medicinal doses, but it does not seem to affect the tem- 
perature of healthy individuals, as Dr. Justus Andeer, experimenting 
upon himself, took as much as 10 grammes without observing a reduc- 
tion of body-heat 

The antipyretic action is more marked in typhoid fever, pneu- 
monia and erysipelas than in other febrile states, although it is present 



526 MATERIA MEDICA AND THERAPEUTICS. 

to some extent in malaria, and indeed it appears to possess some anti- 
periodic power, as might be inferred a priori from the close chemical 
relationship which it bears to quinine, to which, however, it is very far 
inferior in this respect. It is well borne by the stomach. The de- 
crease in the temperature of fever is usually preceded by transient 
vertigo, tinnitus aurium, flushing of the face, headache and oppression 
in the chest. As the temperature declines there is nearly always a 
profuse perspiration, and the pulse and respiration, which were at first 
accelerated, are markedly slowed. This occurs in about one hour 
after the ingestion of the drug and continues for from two to four 
hours, and is then followed by a more or less well-marked chill and a 
gradual rise in temperature. Elimination takes place rapidly, chiefly 
through the urine. 

Toxicology. — When a large dose is given to an animal, trembling 
supervenes, soon followed by general epileptiform convulsions, each 
occupying a few minutes only, which regularly increase in severity, 
reach their maximum and as regularly decline. The general sensibility 
is not affected. The convulsions appear to be of spinal origin. The 
pulse is weak, rapid, and irregular, the breathing accelerated, convul- 
sive, then shallow and weak, and finally death takes place from failure 
of respiration, preceded by a rise in temperature from excessive mus- 
cular action. 

Medicinal Uses. — As an antipyretic resorcin has been somewhat 
employed in typhoid fever, pneumonia, erysipelas, acute rheumatism, and 
septicemia. As a sedative and antifermentative it is used in the acnte 
diarrhoea of children, chronic gastritis, gastrodynia and dyspepsia due 
to the fermentation of the ingesta, for which purpose it may be advan- 
tageously combined with sodium bicarbonate. 

Topically, it has been applied as an antiseptic to unhealthy ulcers 
and wounds, and to destroy fetor and promote healthy granulations. 
Unna recommends a 5 or 10 per cent, ointment in phthiriasis capitis, 
squamous eczema of the head and in seborrhoeal eczema. In psoriasis 
an ointment of the strength of 10 to 20 per cent, may be used with 
advantage. The powder or a strong ointment may be applied in 
parasitic sycosis with marked benefit.* Possessing as it does the 
property of softening dermal callous growths, it may be applied in 
watery solution gr. x-xxx to §i to horny eczema, and kept on with 
oil-silk. 

* Cenlralbl. f. die ges. Therap., Mar. 1886, Ihle. 



ANTISEPTICS AND ANTIPYRETICS. 527 

According to Dr. Jackson,* it is very useful in epitheliomatons 
lesions where surgical interference is contraindicated, as it exerts a 
powerful absorptive effect on new cell-infiltrations. Pure resorcin has 
also been powdered on condylomata of the penis, vulva or anus with 
brilliant results. f It is also used in solution of various strengths in 
various diseases of the mucous membranes, as in acute or chronic 
conjunctivitis ; as a disinfectant, antiseptic, and in strong solutions, as 
a caustic in laryngeal diseases. In tubercular ulceration of the larynx, 
the pain soon subsides and the cough diminishes after these applica- 
tions. 

In gleet a 2 per cent, solution may be injected into the urethra 
with excellent effect (Dr. Justus Andeer,| Righi, op. cit). 

Administration. — The ordinary dose is gr. iij-viij, either in 
capsules or in solution in alcohol, glycerin or water, disguised with 
syrup of orange-peel. These doses may be repeated every four hours. 
The maximum quantity in 24 hours is gr. 45. A good liquid form is 
as follows: 1^ Resorcini, Siiss, infus. gentianae co., fSjv. M.S.-5^ 
every 4 hours. For topical application it may be made up with vase- 
line, 5 to 20 per cent. ; or dissolved in water. 

Hydroquinone or Hydrochinone (para-oxyphenol) and Pyrocatechin 
(ortho-oxyphenol), neither of which are official, are isomers of resor- 
cin, as has already been pointed out. Their effects are identical with 
those of the latter, than which they are about four times as powerful. 
They are little used, being superseded by acetanilid and other anti- 
pyretics of more recent date, although, by some, hydroquinone § is 
thought to be among the most powerful and least harmful remedies of 
this group. 

ACIDUM SALICYLICUM— SALICYLIC ACID. 

This acid, although known for nearly half a century as a deriva- 
tive of salicin (see p. 164), has been employed only since 1875 as an 
article of the Materia Medica. 

Preparation. — It has been prepared from the flowers of Spircea 
ulmaria or Meadow-Szveet, and from the oil of gaultheria (where it 
exists as methyl salicylate). Salicylic acid (HC 7 H 5 3 ) is now made by 
combining the elements of pure carbolic acid with dry carbonic acid 
gas and purifying. 

* Journ. Cutan. and Genit.-Urin. Diseases, Vol. v, Nos. 6 and 7. 

f Russ. Meditz., No. 38, 1886, p. 639, Gatchovsky. 

\ Centralbl. f. die gesammte Tkerap., Apr., 1884. 

\ Berliner Klin. Wochensch., No. 29, 1884, Dr. P. Seifert. 



528 MATERIA MEDICA AND THERAPEUTICS. 

Properties and Test. — It is obtained in the form of minute, 
broken, acicular crystals (having usually the appearance of a pale- 
pinkish granular powder), which are bleached with great difficulty. 
It is odorless and nearly tasteless, leaving, however, slight acridity in 
the fauces. It is practically insoluble in cold water, but quite soluble 
in boiling water, a hot aqueous solution retaining when cold, in 
proportion to its coldness, I part in from 250 to 500 parts of the 
solution. The addition of two parts of sodium sulphite, or 1 part of 
ammonium phosphate, or three parts of sodium phosphate, renders it 
much more soluble in water. It is freely soluble in alcohol, ether and 
glycerin. Test. — Dissolved in water, a fine violet color is produced on 
the addition of ferric chloride. 

Incompatibles. — The ferric salts, alkalies, and mineral acids. 

Aids. — Antiseptics, antipyretics, and cardiac depressants. 

Physiological Effects. — In its effects salicylic acid is allied to 
carbolic acid. It destroys micrococci in solution (dissolved with borax) 
1 : 400 (Abbott); the pus cocci in 2 hours, with 2 per cent. (Stern- 
berg) ; a 1.6 per cent, solution kills the typhoid bacilli in 5 hours, the 
cholera spirillium by 1.3 per cent. (Kitasato). By Miquel its antiseptic 
power is put at I : I, OOO. A peculiar property of salicylic acid is its 
power to soften the epidermis. It is , devoid of smell or notable taste, 
is not volatile, and is also, in quantities necessary for effective action, 
free from irritant or poisonous influence. Its taste is sweet with a slight 
astringent after-taste. Moderate doses are without effect upon the 
stomach ; large amounts cause nausea and often vomiting. It is 
probably absorbed as a sodium salicylate. Secretion : full doses cause 
free diaphoresis which is often exhausting. It somewhat favors the 
secretion of milk, and the amount of sugar in that secretion is height- 
ened.* The urinary flow is augmented and the proportion of urea, 
uric and phosphoric acids in the urine increased. When given in full 
medicinal doses buzzing and roaring in the ears, with fullness in the 
head are experienced, which are much increased after the administra- 
tion of larger doses, amounting even to deafness and partial blindness. 
If an excessive dose be taken all the symptoms are intensified, and great 
restlessness, followed by delirium, involuntary evacuations, stupor, and 
in the lower animals convulsions, are observed. The action of salicylic 
acid upon the ear (as well as the similar action of quinine) has been 

* Deutsches Arch. f. Klin. Med., Jan., 1882; Bull. Gen. de Therap., Fevrier, 1SS9, 
p. 119. 



ANTISEPTICS AND ANTIPYRETICS. 529 

investigated with varying results. Kirchner concludes that these 
remedies produce intense congestion of the tympanum and labyrinth 
(due to vaso-motor disturbance), which may lead to changes in the 
nerve-filaments ; while Weber- Liel and Guder * found anaemia of these 
parts as the result of the ingestion of the drug. 

The heart-beat is first increased in frequency, but afterward slowed ; 
excessive doses cause the pulse to become slow and labored. The 
blood-pressure is at first elevated (from the action of the acid on the 
heart and on the vaso-motor centres), then lowered. Blood : Prudden,f 
from experiments upon frogs, verified on rabbits and on the human 
blood, concludes that salicylic acid restrains the migration, and in 
strong solutions is inimical to the life, and in weak solutions to the ac- 
tivity, of the white blood corpuscles. Respiration is at first quicker 
and deeper than normal from the action of the drug on the vagi and 
to some extent on the respiratory centre; later it becomes slow and 
labored, and death results from asphyxia. Temperature : non-toxic 
doses have little or no effect upon the normal temperature ; in fever, 
however, salicylic acid causes a marked reduction in the body-heat 
which lasts several hours. 

Elimination takes place slowly, partly as a salicylate, a good deal 
unchanged, and a portion as salicyluric acid and salicin. After the 
ingestion of large quantities the urine will be colored green from an 
increase of the indican. Whether employed internally or externally a 
portion passes into the urine unchanged and gives, with ferric chloride, 
a blue or violet reaction. The acid retains its antiseptic properties 
only so long as it remains in the free state. 

Medicinal Uses. — For its antipyretic effects salicylic acid has 
been used in fevers with varying success. In acute rheumatism, es- 
pecially in robust patients, it is preeminently of value, reducing the 
temperature, relieving the joint-affection and ameliorating the pain; 
but whether it shortens the duration and decreases the frequency of 
cardiac complications (as endocarditis} and relapses is still disputed. In 
some an intolerance of the drug appears at once, symptoms of gastric, 
ocular and auditory disturbance setting in with the first two or three doses. 
Sodium salicylate is the usual form of exhibition. In rheumatic hyperpyr- 
exia it is of value, but it should not be relied on to the exclusion of other 
means of reducing temperature. In gonorrhoeal rheumatism and gout, 

* Med. Record, Oct. 28th, 1882. 
f Am. Jour. Med. Set., LXXXII, 1882. 
34 



530 MATERIA MEDICA AND THERAPEUTICS. 

where no kidney complication exists, it is also of service, and in 
puerperal fever, dengue, chronic and muscular rheumatism, etc.; although 
not as effective in these diseases as in rheumatism, and, indeed, it has 
been condemned by some as being of no avail. It is serviceable in 
acute tonsillitis in doses of gr. x every two to four hours.* As an 
antizymotic to prevent fermentation of the ingesta its use is advised in 
acute gastritis, gastric dilatatio7i, eructation and sarcina. As an anthel- 
mintic salicylic acid has been prescribed with success against tape- 
worm, and is also internally and locally used against ascarides. Topi- 
cally, it is applied in the moist stages of eczema and eczema rubrum 
with good results, and in the form of ointment to tinea versicolor, 
tonsurans and circinata. 

As a detergent and desiccant it may be sprinkled dry on wounds 
or ulcers in the form of powder, or mixed in various proportions with 
some inert powder, as starch ; or a solution, I part to 300 parts of 
water, may be used as a substitute for the antiseptic carbolic dressing ; 
the stronger solution with sodium phosphate, 1 part to 50 parts of 
water, is used to wash or spray foul surfaces, or as an application in 
diphtheria. Salicylic acid sprinkled over warts and corns y and retained 
by rubber plaster several days, then removed, the parts scraped and 
the dressing reapplied, will remove their growth. Fetor of breath can 
be corrected with a 5 gr. to the f5i of warm water mouth-wash. 

Administration. — Dose, gr. x-5j, either in capsules or it can 
be had in compressed pills of various strength, and in elixir, gr. 
ij to f5i. The following solution makes an excellent application to 
inflamed or painful corns: 3^ Acidi salicylici, gr. x; collodii flexilis, 
f5j. M. 

Sodii Salicylas (Sodium Salicylate) (NaC 7 H 5 3 ) is a white crys- 
talline powder, without smell, soluble in water, having a sweetish alka- 
line taste. 

Internally, its effects and uses are identical with those of salicylic 
acid (q. v.), to which it is preferred, because it is soluble in water, and 
causes less gastric irritation. It may be prescribed in water ; it is 
kept in pill form in the shops. 

Lithii Salicylas [Lithium Salicylate) (LiC 7 H 5 3 ) is employed inter- 
nally to fulfill the indications of salicylic acid. The salts are given in 
doses corresponding to those of the acid. It is very soluble in water. 
It can be had in compressed pills, gr. v. 

* Brit. Med. Jour., Oct. 14th, 1882, Dr. Edward Mackey. 



ANTISEPTICS AND ANTIPYRETICS. 531 

SALOL. 

Description and Properties. — Salol (C 6 H 5 C 7 H 5 3 ) is an ether- 
combination of salicylic acid, 60 per cent, and . carbolic acid, 40 per 
cent. It is not a salicylate of phenol, as has been erroneously stated 
in some quarters, but a salicylic-phenol-ether, and occurs as a white, 
tasteless powder, having a faint odor resembling carbolic acid, slightly 
unctuous to the touch, insoluble in water, but easily soluble in alcohol, 
in ether, and in the fixed and volatile oils. 

Physiological Effects. — It is antiseptic ■, not germicidal, for, like 
iodoform, it will prevent the formation of bacteria, but does not destroy 
them when actually present (Nencki). Locally, being insoluble it does 
not irritate the skin nor the surface of wounds when applied to them, 
and hence may well replace iodoform in local antisepsis. When salol 
is taken with food it is said to pass unchanged and undissolved through 
the stomach into the duodenum, where, under the action of the pan- 
creatic juice, it is converted into carbolic and salicylic acids; hence 
it will act as a'n intestinal antiseptic without affecting the stomach. It 
is said, too, to render the bile more fluid and augment the flow. When 
administered internally, it reduces febrile temperatnre, but has no influ- 
ence over that of health. This antipyretic action is very marked, 
occurs suddenly fifteen minutes after salol has been taken, and is to a 
certain extent independent of the amount administered;* that is to 
say, repeated doses will not lower a temperature already reduced by 
a single dose, although they will maintain the reduction. Simultane- 
ously with the decline of the fever sweating occurs, as in the case of 
the other agents of this group, but it is not marked, nor do the chilly 
sensations which sometimes precede the rise of temperature ever 
amount to a distinct chill. f The circulation is but little influenced, 
even by large doses of salol (Lombard loc. cit), but the respirations 
increase rapidly, so much so that at the expiration often minutes after 
taking the medicine, they have doubled in frequency, at the same time 
becoming very shallow, and although they are soon slowed, yet some 
time elapses before they return to their normal depth. Salol also 
possesses analgesic properties in common with other antipyretics of 
the aromatic series of carbon compounds, but this subject has as yet 
not been sufficiently investigated to warrant a positive statement 
regarding its cause. 

* Bull. Gen. de Therapy i5ieme, 1887, Dr. Lombard. 

f Deutsch. Med. Wochenschr., No. 19, 1887, Dr. Herrlich. 



532 MATERIA MEDICA AND THERAPEUTICS. 

It is eliminated principally through the kidneys, under the form 
of salicyluric acid and phenol-ether-sulphuric acid, the latter imparting 
the dark color to the urine, although during a course of salol the urine 
assumes a dark hue, similar to that seen when large amounts of car- 
bolic acid are taken. No toxic symptoms have been observed, and it 
is believed to be innocuous. 

Medicinal Uses. — Salol has been employed in acute rheumatism 
to lower the temperature and relieve the pain, and although it does 
this most promptly, its effects are much more evanescent than are 
those of sodium salicylate. It neither prevents relapses nor lessens 
the tendency, to cardiac complications. 

It has been found serviceable in intestinal catarrh, especially when 
the upper part of the tube is affected ; thus in catarrh of the duodenum 
it is of special value, as it is there that it is re-converted into its con- 
stituent parts. Salol in diarrhoea* when the stools are unusually fetid, 
by reason of its antiputrefactive properties, often renders valuable aid, 
particularly when combined with suitable dietetic treatment, and under 
its influence they lose their fetor and regain their normal consistence; 
^ Salol, 5i; bismuth sub. nit., 5ij ; mist, cretae, ad foiij. M. S. — 5ij 
every 2-4 hours. 

Prof, von Nencki and others recommend it in the treatment of 
acute cystitis, since it has been found to entirely prevent the decom- 
position of urine when mixed with it ; and since its component parts 
are eliminated unchanged by the kidneys, a similar effect probably 
follows its internal administration. For a similar reason it is advised to 
prevent urinary decomposition in the phosphatic diathesis. Salol (gr. 
3^) is prescribed advantageously m gonorrhoea, combined with oleo- 
resin of cubebs (Ttlv), copaiba (Tltx), and aseptic pepsin (gr. ¥0^0) — 
known as compound salol capsules. 

Like many of the antipyretics, it possesses the property, when 
administered internally (gr. iij-x, t. d.) of relieving the pains of neuritis, 
neuralgia, etc., to a remarkable degree, and it also exerts a similar, 
though less marked influence, over myalgia and other muscular pains. 

Topically, it has been used as an antiseptic in the dressing of 
ulcers. 

Administration. — Salol may be given in capsules, pills (com- 
pressed and round) or in powder. The dose ranges from gr. v-5j. 

* Bull. Gen. de Th'erap., t. ii., 1891, Egasse; also Therap. Gaz., Aug. 15, 1892, 
Fussell. 



ANTISEPTICS AND ANTIPYRETICS. 533 

As an antipyretic the average dose is gr. xv-xxx, and as much as 5ij- 
iij have been administered in twenty-four hours without deleterious 
effects. Children of 2 to 4 years may take gr. iv-vj ; 1 1 to 15, gr. xii- 
xv. It may be applied to burns, salol 1 part, olive-oil and lime-water 
each 60 parts : as an antiseptic powder equal parts of salol and starch 
well pulverized. 

NAPHTHALINUM— NAPHTHALIN . 

Description and Properties. — Naphthalin (C 10 H 8 ) is a hydro- 
carbon made from coal-tar, and, when pure, occurs as thin, white, 
shining laminae, having a strong, pungent odor and a burning taste, 
insoluble in water, diluted acids or alkalies, but dissolving in alcohol, 
ether and oils. * 

It was introduced into medicine as an expectorant, and stimulat- 
ing application^ but was first used as an antiseptic by Dr. E. Fischer,J 
in 1 88 1, who recommended it as cheap, innocuous, and as efficacious 
as carbolic acid. 

Physiological Effects. — Naphthalin is disinfectant, deodorant, 
antifermentative and antiseptic, whether applied locally or administered 
internally. It has no antipyretic action. It possesses some parasiti- 
cidal power. It has a burning aromatic taste. It does not irritate 
the stomach — in fact, it is believed to pass unchanged through that 
organ into the intestines, and there to act as an antiseptic, rendering 
the stools inodorous, or imparting to them its own odor to a slight 
degree. Although very insoluble, it is to some extent absorbed, and 
eliminated by the lungs and kidneys, imparting a dark color to the 
urine (Binz), and in large doses irritating the kidneys, and even in 
some cases causing violent cystitis, with strangury.§ In medicinal 
doses, it retards or prevents the decomposition of the urine, and hence 
is of value in cystitis. It is not toxic, probably because of its insolubility. 

Medicinal Uses. — It is chiefly used internally^ as an antiseptic 
in the treatment of gastro-intestinal, renal, and cystic disorders. 

In dyspepsia due to fermentation of food ; in acute gastro-intestinal 
catarrh (combined with opium) ; in chronic gastro-intestinal catarrh, to 
prevent fermentation and the consequent nausea, heartburn and eruc- 
tations, it is highly recommended. 

* Wienner Med. Blatter, No. 28, 1885, Binz. 
f Journ. de Pharm. et de Ckim., 1842, Dupasquier. 
X Berlin Klin. Wochensch., XIX, 1882, p. 113-116. 
§ Ibid., No. 42, 1884, Rossbach. 
j| Cf. Binz ; op. cit. 



534 MATERIA MED1CA AND THERAPEUTICS. 

In chronic diarrhoea and dysentery it has also proved of use in 
checking intestinal decomposition, but would appear to act more bene- 
ficially when combined with an evacuant plan of treatment than when 
given alone. 

It is also recommended in typhoid fever as an intestinal antiseptic. 
In pyelonephritis, acute or chro7iic cystitis, chronic prostatitis with reten- 
tion and decomposition of urine, and in cases of old stricture with 
multiple fistulae, and aimnoniacal urine, in doses of gr. xx, it is said 
rapidly to render the urine sweet, limpid, neutral or acid in reaction, 
while it causes the pus to diminish or disappear altogether from that 
fluid. 

It has also been successfully employed to cause the expulsion of 
parasites from the alimentary canal, and, may be administered for this 
purpose to children in cases of round or thread-worms in doses of gr. 
j-iij, t. d., or to adults with taenia, gr. xx-lxxx daily in divided doses 
(Koriander). 

Topically, naphthalin has been much lauded as a substitute for 
iodoform in the antiseptic treatment of wounds, abscesses and ulcers, 
either venereal or common ; and it has been used as a surgical dress- 
ing after surgical operations, and even after amputations, but it does not 
appear to possess any special advantage over the stronger antiseptics 
(as corrosive sublimate) when carefully used. 

Administration. — Dose, gr. ij-x, t. d., or up to gr. 80 for an adult 
in 24 hours. It is best administered in compressed pills or in capsules. 
Topically, it may be used either in the form of powder, ethereal solu- 
tions (5ss-j in ether fSss) or ointment with vaseline. The peculiar and 
disagreeable odor of naphthalin can be altered and even rendered 
pleasant by trituration with a small quantity of the oil of bergamot.* 

Salophen (not official), Acetyl-amido-salol, has attracted some 
attention as a substitute for the salicylates, as being unirritating, taste- 
less and not depressing. Dose, gr. xv-xx, 3 or 4 times daily. 

NAPHTOL— NAPHTOL. 

Description and Properties. — This substance (C 10 H 7 OH) is 
totf-naphtol, a phenol occurring in coal-tar, and is usually derived 
from naphthalin. It occurs in the form of white crystals of carbolic 
odor, almost insoluble in water, but miscible in alcohol, ether, chloro- 
form and most of the oils. 

* Am. Druggist, Jan., 1885, p. 17. 



ANTISEPTICS AND ANTIPYRETICS. 535 

Incompatibles. — With subacetate of lead it forms a white creamy 
precipitate. Though practically insoluble in water, its alcoholic solu- 
tion may be safely diluted 50 per cent, with water. 

Aids. — Topically by creosote and carbolic acid. 

Contraindications. — As it is eliminated by the kidneys, making 
the urine turbid and sometimes albuminous, it should not be adminis- 
tered when the renal apparatus does not perform its functions normally. 

Physiological Effects — Locally, it is quickly absorbed ; when 
applied to the delicate tissues in aqueous solution (gr. ij to f§j) it sets 
up a temporary sense of irritation and burning, but if dissolved in a 
fatty substance (10 or 20 to 100) and rubbed on the healthy skin no 
irritation is provoked. When applied too freely it may become 
absorbed to the extent of inducing toxic effects, as vomiting, convul- 
sions and hsematuria. Beta-naphtol in weak solution prevents com- 
pletely the development of various kinds of microbes, as those of 
yeast, the micrococci of pneumonia and of suppuration ; and it retards 
the growth of the bacilli of typhoid fever and tuberculosis. It prevents 
the decomposition of the urine, and organic substances in full putre- 
faction cease to putrefy when brought in contact with it. Its taste is 
sharp and pungent, but not persistent. Within the stomach about 
Svj^ to a man weighing 145 lbs. induce decided phenomena of intox- 
ication, while toxic symptoms begin to come on when the quantity 
reaches giij, whether introduced by rectal injection or the stomach. 
Compared with tf-naphtol it is more than y 2 less toxic, but possesses 
J^ weaker germicidal powers. Naphtol readily destroys canine life. 

Medicinal Uses. — But little experience has been recorded with 
this remedy for internal use ; it has, however, been given gr. 25 to 40 
in the 24 hours in capsule, as an antiseptic agent in typhoid fever. 
Naphtol, by reason of its germicidal virtues, is adapted to the treat- 
ment of cutaneous parasitic diseases. In the management of favus and 
prurigo, either as a soap (2^ per cent.), or pomade (5 per cent.), 
applied alternately with sulphur- soap and friction at night, Kaposi 
praises this medicament highly ; while against scabies one day's treat- 
ment with frictions, the same observer found sufficient to effect a cure 
in a large number of cases. It is also applicable to the treatment of 
tinea versicolor and circinata. In psoriasis it is less efficacious than 
chrysarobin. Naphtol has been employed, too, to assist the cicatri- 
zation of chancroids and idcers. 

Administration. — Dose, gr. v-x t. d., or oftener, in capsule. For 
topical use a pomade, 10 parts of naphtol to vaseline 100, and an 



536 MATERIA MEDICA AND THERAPEUTICS. 

alcoholic solution, 20 to 40 of the remedy to 100 of fluid, are employed. 
Caution is enjoined with this remedy.* 

ANTIPYRINE. 

Description and Properties. — Antipyrine (not official), a synthet- 
ically prepared base which combines readily with acids, forming salts 
similar to those of ammonia, is a whitish, crystalline powder, very solu- 
ble in water. 

Incompatibles. — Spirit of nitrous ether or nitrous acid forms 
isonitroso-antipyrine ; decoctions, tinctures and infusions containing 
cincho-tannic acid are precipitated by antipyrine. With strong solu- 
tion of chloral a globular oleaginous precipitate goes down, and ferric 
chloride forms a blood-red color. Most of the metallic salts form 
precipitates or colors with this agent. Sodium salicylate (solid), 
sodium bicarbonate and tincture of iodine are also incompatible. f 

Physiological Effects. — Locally, it is antiseptic and antifermen- 
tative. The internal action of antipyrine is very similar to that of other 
antipyretic remedies. It has a sweetish-bitter taste. Upon the heat- 
functions of the normal animal it is without action. By Cerna and Carter J 
the reduction of temperature in the febrile state " is due to a great in- 
crease in heat dissipation, together with a fall in the heat production." 
The perspiration which accompanies the decline of temperature may be 
very profuse, but after the period of apyrexia, which lasts from four to 
twelve hours or even longer, the return of fever, although sometimes 
ushered in by a chill, is much less apt to be characterized by a severe 
rigor and even collapse than is the case with kairin or thalline. Anti- 
pyrine, in moderate doses, increases to some extent " the power of 
contraction of both auricles and ventricles " (Beyer), and hence is a car- 
diac tonic. It elevates the arterial pressure to a slight degree. Toxic 
amounts lower the blood pressure by a depressant action on the heart ; 
the latter generally stops in diastole. 

In excessive quantity the haemoglobin is changed into methsemo- 
globin. Like many other antipyretics it depresses the reflexes and 
is analgesic. It is excreted chiefly by the kidneys and may be de- 
tected in the urine for two or three days after its administration has 



* On Naphtol, see Egasse's article Bull. Gen. de Therap., 1891, t. 120, p. 399. 
I See Helbing's Modern Mat. Med , 1894. 

J Notes on New Remedies, Sept., 1892; and Am. J. M. Set., Apr., 1886, p. 402, 
Beyer. 



ANTISEPTICS AND ANTIPYRETICS. 537 

been suspended.* Occasionally antipyrine causes the appearance of a 
cutaneous eruption, usually erythematous, but sometimes papular or 
vesicular. 

Medicinal Uses. — Antipyrine is employed, as its name implies, 
as an antipyretic and analgesic agent. For the former purpose it is 
probably more generally employed than any other remedy to reduce 
fever temperature. In typhoid fever and scarlet fever, when the tem- 
perature is high, if the cold bath or pack be impossible, antipyrine is 
oT great value, but it possesses no more power over the disease-process 
than do the other remedies already discussed. In tuberculosis, gr. xv 
at the onset of the fever, repeated if necessary, will be found efficacious, 
and in acute rheumatism numerous observers attest to its good effects, 
not only in lowering the temperature, but also in relieving the pain. 
It does not, however, lessen the danger of cardiac complications, nor 
the liability to relapse. In sunstroke with high temperature it acts 
most beneficently. It has also been advantageously administered in 
erysipelas, pneumonia, the various exanthemata, measles, etc., and sur- 
gical fever. It is not an antiperiodic, and although it may be used to 
moderate the fever of malarial affections, it will not prevent the return 
of the paroxysm. It is prescribed, too, in hay-fever and influenza, and 
to antagonize inflammation. 

As an analgesic it is a valuable addition to our armamentarium. 
For the purpose of palliating the pain of muscular rheumatism, lum- 
bago, herpes zoster, neuralgia of the superficies, of preventing an attack 
of asthma, in fact as a succedaneum of morphine, Dr. A. Wolff f finds, 
as the result of numerous experiments, in the subcutaneous injection 
of antipyrine, an efficient and quickly-acting remedy, and one which is 
not succeeded by inflammation at the seat of introduction. The 
" lightning pains " of locomotor ataxia and the bone-pains of dengue 
are often promptly relieved by doses of gr. x-xv repeated as necessary, 
and various neuralgic affections, as sciatica, tic-douloureux, headache, and 
other nervous conditions characterized by pain (Germain See) are 
often cured by its timely administration. In muscidar rheumatism and 
myalgia it has, too, been used with good results. 

Antipyrine in doses of gr. x-xv will often allay the pain in the 
first stages of labor without apparently interfering with the process of 
dilatation of the os uteri. It is prescribed also as an antipyretic in puer- 
peral fever. 

* Rev. de Therap., Mai 15, 1887. Prof. Germain See. 
f Therapeittische Monats., No. 6, 1 888; quoted. 



538 MATERIA MEDICA AND THERAPEUTICS. 

Administration. — Dose, gr. v-5j. The average dose as an anti- 
pyretic is gr. xv-xxx, repeated ; as an analgesic gr. x-xv, repeated in 
from one to four hours if necessary. Children may take about gr. i^ 
for each year of age, t. d. It may be administered either in aqueous 
solution or in capsules, in compressed pills, or, as it is readily soluble, 
by hypodermic injection. (See Appendix.) 

Antipyrine salicylate or salipyrin (not official), a white, insoluble 
powder with a sweetish taste, has been given in acute and chronic rheu- 
matism and influenza* with success. It is free from cardiac influence 
and is not toxic, 02^ having been taken in 3-4 hours. Dose, gr. xv, 
repeated, in capsules. 

Many of the essential oils as well as the camphors obtained from 
them have proved to be antiseptic. Among these may be mentioned 
the oils of cloves, gaultheria, peppermint and thyme (q. v.); menthol, too, 
(v. p. 232), derived from the oil of peppermint, is a local anaesthetic as 
well as antiseptic, and has been considered under the head of aromatic s, 
but thymol (see p. 545), deserves a more extended notice as an anti- 
septic. 

phenacetine. 

Preparation. — This remedy (not official) (C 10 H 13 NO 2 ) is a crystal- 
line body produced by the action of glacial acetic acid on para-pene- 
cidin, a substance obtained from phenol. 

Properties. — It occurs in colorless, tasteless, glistening, scaly 
crystals, sparingly soluble in cold water, but miscible in 16 parts of 
rectified spirit. 

Physiological Effects. — This medicament was introduced as an 
antipyretic in 1887 by Hinsberg and Kast ; its action in this respect is 
free from collapse, though accompanied by profuse perspiration. It is 
without influence on the normal temperature. Carter and Cerna t 
found that the fall of febrile temperature was due to the lessened pro- 
duction of animal heat, the result of a direct influence on the thermo- 
genic centres, together with a slight decrease in heat dissipation. It 
has also decided analgesic properties. In moderate doses Carter and 
Cerna (Joe. cit.) found that it caused a rise in arterial pressure, while 
large reduced the same, due in part to a depressant action on the 
heart. Hare, however, affirms that it has but little influence over the 
circulation. It destroys canine life by respiratory paralysis. 

* Deuts. Med.-Zeinal, Dec. 7th, 1893, Von Mosengeil. 
f Notes on New Remedies, Sept. 1892. 



ANTISEPTICS AND ANTIPYRETICS. 539 

Medicinal Uses. — It is given in the same class of diseases to 
reduce temperature as antipyrine, viz. : typhoid fever, pneumonia, in- 
fluenza, etc., and when the fever is accompanied by insomnia and irri- 
tability its antipyretic effects, though slow, are often followed by quiet 
sleep and no headache afterward. As an analgesic it has considerable 
reputation, being administered with success in the various neuralgics, 
headache and migraine. 

Administration. — Grains 5-15 every two hours, or even oftener; 
5i/^ may be taken in 24 hours. For a child of 2, gr. ii-iv ; 11 to 15, 
gr. vi-viij. It may be dispensed in powders or tablets. 

PHENOCOLL HYDROCHLORIDE. 

Preparation. — This new antipyretic (not official) is formed by 
the interaction of phenetidine and glycocoll. It is the hydrochloride 

{OC H 
NH.COCH,NH,HCl. 

Properties. — It occurs as a white, crystalline powder, soluble in 
about 16 parts of water, and forms a neutral solution. 

Incompatibles. — Ammonia, the fixed alkalies and their carbon- 
ates, precipitate the base in solution. 

Physiological Effects. — Its taste is slightly bitter. No dis- 
turbance of the digestive functions have been noted. Upon the normal 
body-heat it has no action. When given in fever it causes a decided 
reduction in temperature in the first hour, this being due to a diminu- 
tion of heat-production. Medicinal doses exert no influence upon 
the circulation ; large amounts reduce the blood-pressure by cardiac 
action. It has no action upon the blood. The respiratory movements 
are quickened. Analgesic properties are ascribed to it. 

This new remedy * has certain advantages over the older anti- 
pyretics, viz.: reduction of temperature without depressant action on 
the circulation, solubility and rapidity of absorption. 

Medicinal Uses. — It is prescribed to reduce temperature in 
febrile affections^ and as an anti-neuralgic. 

Administration. — Dose, gr. 8-15; in 24 hours, 5 1^. It may 
be dissolved in water gr. xv to the foj, or taken in powder or capsule. 

iodoformum— iodoform. 
Preparation and Properties. — Iodoform is obtained by the 
action of chlorinated lime upon a heated alcoholic solution of potas- 

*Helbing's Mod. Mat. Med.; Notes on New Remedies, Sept., 1892. 
-j- Medicins. Wochen., St. Petersburger, 1894, Kucharzetaki. 



540 MATERIA MEDICA AND THERAPEUTICS. 

sium iodide, which yields calcium iodate and iodoform, the latter being 
separated by the solvent action of boiling alcohol. It is formyl terio- 
dide (CHI 3 ), and occurs in the form of small, scaly, yellow crystals, 
having a persistent saffron-like odor and sweet taste, insoluble in 
water, but soluble in alcohol, ether, chloroform, and the fixed and 
volatile oils. Its molecule contains rather more than 95 per cent, of 
iodine. 

Incompatibles. — With corrosive sublimate. 

Physiological Effects. — Locally, it possesses no germicidal 
power, but prevents the growth of bacteria. When applied as a 
powder to a wound it tends to check serous oozing, a state advanta- 
geous to the development of bacteria. When moistened with water 
iodine is liberated, the presence of which exerts a certain degree, of 
antisepsis. Applied to instruments or the surface of an intended oper- 
ation, it does not affect asepsis. Its taste is sweetish and iodine-like. 
Full doses cause vomiting and diarrhoea (in dogs). Secretion : it 
increases the salivary, biliary and intestinal flow. According to Dr. 
G. Rommo,* Mikhail, P. Poliakoff, and others, the effects of iodoform 
are as follows : Nervous system ; in warm-blooded animals, iodoform 
at first lowers the functional activity of the nerve-centres ; voluntary 
motion is next affected and finally abolished (especially in frogs) ; 
anaesthesia is present to some extent, and the reflex functions of the 
cord are depressed ; the excitability of the nerve-trunks to external 
stimulation is lessened, as is also muscular contractility. A period 
ensues, if a sufficiently large dose has been taken, during which there 
is excitation of the nerve-centres, with clonic and tonic contractions 
of the muscles. Circulation : the capillaries in the web of the frog's 
foot at first dilate, but afterward contract. In mammals, a moderate 
dose primarily retards and strengthens the pulse, at the same time 
slightly elevating the arterial pressure from the stimulation of the 
cardio-inhibitory centre: under full doses, the pulse becomes markedly 
slower and feebler, and the blood-pressure falls. Larger doses at first 
cause slowing of the pulse, which, however, becomes quick and ir- 
regular, from paralysis of the cardiac centre, but this is soon followed 
by secondary retardation and final arrest in diastole, from paralysis of 
the cardiac muscle. Respiration and temperature : moderate doses 
cause a rise in the temperature from 1.8° to 2.7 (in dogs); larger 
doses produce a marked fall of temperature (7. 2° to g° F.) and con- 

* Arch, de Physiol, 1 883. 



ANTISEPTICS AND ANTIPYRETICS. 541 

vulsive respiratory movements. Elimination : it is discharged un- 
changed in small quantities by the lungs, but iodoform mostly passes 
away as alkaline sodium iodate in the urine, which can be found one 
hour after administration. 

Toxicology. — When an excessive dose has been taken, elimina- 
tion is checked, albumen and blood appear in the urine, glomerulo- 
nephritis and fatty degeneration of the liver, heart and other organs 
occur, and an inflammation of the spinal cord, with results similar to 
acute polio-myelitis, is found. Numerous deaths have been reported* 
from its use as an antiseptic dressing. 

Antidotes. — The best preventive to poisoning by iodoform 
consists in remembering that its absorption, even when used exter- 
nally, is much more rapid than its elimination. Accordingly, should 
symptoms of poisoning occur, withdraw every particle of the adherent 
dressing, sustain the system with stimulants and opium, and give large 
doses of potassium bicarbonate (Behringf). 

Medicinal Uses. — Iodoform, in the United States, is seldom pre- 
scribed for internal use. 

External Uses. — It is a local anaesthetic and mild antiseptic, and 
for this end has been found a good application to chancres, balanitis 
and irritable ulcers, and dusted upon corneal ulcers, etc. ; it is used also 
to relieve the pain of cancers, and for this purpose it may be dusted 
over the ulcerated surface, which is then to be dressed with glycerin 
spread upon lint, and it may be powdered over the surface of foul- 
smelling ulcers, to allay their odor. A saturated solution of iodoform 
in chloroform is serviceable in relieving the pain of neuralgia and 
gout ; an iodoform suppository is also useful in painful diseases of the 
rectum and bladder, as hemorrhoids and acute cystitis. Altschul recom- 
mends an iodoform paste as the most efficacious application for burns 
of the second and third degree : 1^ White wax, 5ss ; olei olivae, f§j ; 
liquoris plumbi subacetatis, fSjv ; iodoform, 5ij-iv. M. As an anti- 
septic Mikulicz | found iodoform to be equal to carbolic add, and less 
apt to produce constitutional disturbance from absorption. As a dress- 
ing to open wounds, as bubo and fistula, he found it would check 
profuse discharge, prevent decomposition, and stimulate healthy gran- 
ulations. Into suppurating tracts it may be packed with sterilized 



* La France Med., Nos. 30 et 31, 1882. 
^Deutsche Med. Wochensch., Jan., 1883. 
% Wiener. Med. Wochenschrift, 1 88 1. 



542 MATERIA MEDIC A AND THERAPEUTICS. 

cotton. In treating deep wounds he recommends a pencil composed 
of iodoform, I part, with oil of theobroma, 2 parts. The smell can be 
in part overcome by adding oil ofbergamot, U|j, to iodoform, gr. x. In 
septic, gangrenous, or sloughing wounds it forms an excellent antiseptic 
dressing, and is very useful in chronic or irritable leg-ulcers. Rommo 
(op. cit.) found it more efficacious in preventing the appearance of bac- 
teria than in arresting their multiplication. Burman speaks highly of 
a solution of iodoform, 5j, to collodion, fgx, painted well beyond the 
line of redness in erysipelas. In ophthalmia, in the membranous forms 
of conjunctivitis, and as an antiseptic in ophthalmic surgery, the pure 
drug, finely powdered, is highly recommended. Bougies made with 
iodoform in glycerin and gum-acacia, have been passed into the uterine 
cavity (previously washed out with carbolized water) in puerperal fever 
and allowed to dissolve when septicaemia was feared ; and it has been 
used as an injection in acute gonorrhoea in the proportion of 5v to car- 
bolic acid, gr. jss, glycerin, fSijss, and water, foss. Only one injec- 
tion should be used per diem for three or four days, after which it may 
be used twice daily : it is also applied to the urethra in gelatin-bougies. 
In otoj'rhcea, with much suppuration, iodoform applied by insufflation 
to the auditory canal, previously cleansed and dried, and retained with 
a cotton-plug, gives excellent results. 

Administration. — Dose, gr. j-iij, three times a day, in sugar-coated 
pill or in capsule. In the form !of a fine powder it maybe applied from 
a dusting-box. The ointment {imguentum iodoformi) consists of iodo- 
form, 10 parts, rubbed up with benzoinated lard, 90 parts. The pene- 
trating disagreeable odor of iodoform is an objection to its use. 

ARISTOL. 

The research for a chemical substance endowed with antiseptic 
properties analogous to those already in use, but not presenting the 
inconveniences incident to their employment, has led to the discovery 
of a definite body to which Eichoff has given the fantastic name of 
arisiol* (not official), from dptaroc, meaning superior. 

Preparation and Properties. — Wilgeroth and Vortman obtained 
it by adding to powdered iodine a solution of thymol in an aqueous 
ammoniacal mixture of alcohol, which yielded an oily precipitate, and 
the distillation of the vapor in acetic acid and crystallization gave 
thymol moniodide, that is, one atom of iodine had replaced one atom 

* Bull. Gen. de Therap., Egasse, 1890. 



ANTISEPTICS AND ANTIPYRETICS. 543 

of hydrogen in thymol. By further treatment with iodine the monio- 
dide was made to take up an additional atom of iodine, and aristol or 
dithymol iodide (C 10 H 12 HIO 2 ) resulted. It is an amorphous, reddish- 
brown powder, inodorless, insoluble in cold water and glycerin 
slightly miscible in alcohol, readily in ether, collodion and chloroform, 
and completely blends with the fixed oils, as vaseline. It contains 
about 46 per cent, of iodine. 

Incompatibles. — It is incompatible with the carbonates, the caus- 
tic alkalies, starch and corrosive sublimate, and all substances possess- 
ing affinity for iodine, as the metallic oxides. 

Physiological Effects. — The action of aristol has not yet been 
completely investigated, and for the present we must be content to 
know little be}'ond the fact that while it exerts a destructive influence 
upon certain bacteria, not including the bacillus anthrax, it is neither 
toxic nor irritant when applied to wounds. Upon dogs the subcuta- 
neous injection of an oily solution is not poisonous even to the extent 
of gr. 45 per 2^ lbs. of body- weight. Introduced within the economy 
it is eliminated in part at least by the urine under the form of an 
alkaline iodide, though only about half the quantity injected passes out 
by this channel, and none at all as thymol. The points of injection do 
not become the seat of inflammation. 

Medicinal Uses. — Aristol has been scarcely exhibited internally. 
It is rather as a local succedaneum of iodoform that it has been brought 
to notice, over which it possesses the advantage of being odorless, un- 
irritating and harmless. Those who have used it laud it highly as an 
antiseptic and cicatrant in the treatment of ulcers and cancers. It has 
been applied to such an intractable affection as lupus with benefit, care 
being taken to first snip off the tuberculous ulceration. A 10 per cent, 
solution in flexible collodion is advised in psoriasis (Schuster). A 
number of cases, too, of its successful employment in otorrhoea with 
much suppuration are reported, the auditory canal being cleansed 
previous to the introduction of the remedy: this should be done by in- 
sufflation, and the medicament retained with a cotton wad. The same 
method of treatment in chronic nasal catarrh with scanty and stagnant 
secretions has given good results. But it is not adapted to acute nasal 
catarrh, the nasal mucous membrane not well tolerating the drug. It 
has been also employed to aid the cicatrization of epithelioma. Dusting 
the powder upon the hands poisoned by rhus or dermatitis venenata has 
given good results in J. J. Levick's* hands. Rather more experience 

* Med. News, July 25, 1891. 



544 MATERIA MEDICA AND THERAPEUTICS. 

and statistics will be required, however, to assign to this new remedy 
its proper therapeutical place. 

Administration. — Topically, in ethereal solution I to 10 of fluid; 
with collodium, I to 9 ; a pomade, I part to olive oil 2 parts, and 
lanolin 7; in suppository, gr. 15 to cacao-butter q. s. ; in powder, or in 
soap, 2 per cent. Aristol is not an entirely stable body, since it parts 
readily with its iodine under the influence of moisture and light, passing 
to the moniodide, hence it should be preserved in yellow vials, and 
prescribed alone, though it mixes well with tannic and gallic acids. 

IODOL. 

Preparation and Properties. — Iodol (not official), is obtained 
by the action of iodine on pyrol (C 4 H 4 NH), a constituent of animal 
©ils,* in which iodol or tetra-iodo-pyrol (QI 4 NH) is formed by the 
substitution of 4 atoms of iodine for 4 atoms of hydrogen. It is a 
" light-yellowish-gray, fine and specifically light powder," soluble in 
5000 parts of water, in 3 parts of alcohol, and in about its own weight 
of ether. The addition of water to the alcoholic solution causes a milky 
precipitate. It is very rich in iodine, containing 88.9 per cent. It 
has little taste, and is free from disagreeable odor. 

Physiological Effects. — Locally, when in contact with the tis- 
sues and secretions of the body iodine is readily liberated, but no 
constitutional phenomena have attended its long-continued use as an 
external application. f It is slightly caustic, adhering readily and 
uniformly to the surface of a wound, and forming a gray protective 
film to the granulations underneath. It is said to aid the process of 
cicatrization. \ Its antiseptic power against the microbes of suppura- 
tion described by Fournioux, which is due to the liberation of iodine, 
is about equal to that of iodoform, to which it is preferable from its com- 
parative freedom from nauseous smell and taste, and the absence of 
toxic symptoms attending its external use. It is without germicidal 
power (Sternberg). Even when applied freely to wounds of extended 
surface with much loss of substance, according to Egasse, § although 
dissolved by the secretions and absorbed, no symptoms of poisoning 
have been observed, as is so often the case with iodoform. || Internally, 

* Lancet, Nov. 1885, p. 1013. 

f Practitioner, May, 1887, p. 336. R. N. Wolfenden. 

\ Bull. Gen. de Therap., Fev., 1887. Dr. Juquer. 

\ Bull. Gen. de Therap., t. 2, 1890, p. 443. 

|| Compt. Rend. Soc. de Biol., Paris, 1890, ser. 9, p. 406. 



ANTISEPTICS AND ANTIPYRETICS. 545 

iodol is almost tasteless ; introduced within the stomach it gives rise to 
phenomena similar to those of iodoform, though less toxic. Whether 
applied locally, or administered internally, its presence can shortly be 
detected in the saliva and urine. 

Medicinal Uses. — Internally, it has been given as a substitute 
for iodoform. As a topical application it has been extensively used in 
the treatment of chancres, suppurating buboes, and also in simple indo- 
lent ulcers with good results, and in no case has any erysipelatous or 
diphtheritic inflammation been observed. Dr. Petersen, of St. Peters- 
burg, however, applying it as a dusting-powder to chancroids, three or 
four times daily, observed that usually about the third day the granu- 
lations become flabby, " as if hyaline," and that the granulation process 
was retarded. Iodol has been much lauded as a substitute for iodoform 
in ophthalmic practice, particularly in chronic conjunctivitis, and in 
sluggish corneal ulcers, * but it is contraindicated in affections of acute 
irritative character. According to Katzauroff, iodol always caused 
much more irritation than iodoform, when the powder was applied to 
a healthy eye, and it did not prove as useful in his hands, except in 
phlyctenidar conjunctivitis, trachoma and opacities of the cornea, in which 
it was of great value. 

In nasal, laryngeal and pharyngeal affections it is highly recom- 
mended, particularly in laryngeal phthisis, in which it is often of signal 
value (R. N. Wolfenden). 

Administration. — Dose, gr. ^-ij, in capsule or pill. Topically, 
to the eye or throat it is used in powder or in alcoholic solution diluted 
with glycerin (iodol I part, alcohol 16 parts, glycerin 34 parts), and to 
wounds in powder, solution, ointment, (1 or 2 per cent.), bougies, 
wool or gauze. 

THYMOL. 

Preparation and Properties. — Thymol (C 10 H 14 O), called also 
cymylic phenol, is a solid crystalline phenol found in the volatile 
oil (oleum thymt) distilled from thymus vulgaris (vide p. 233). It is 
purified by rectification, and occurs as large, colorless, rhombohedral 
crystals, having an aromatic odor and an aromatic taste; slightly 
soluble in water, but-very soluble in ether and alcohol. 

Physiological Effects. — Thymol is a powerful antiseptic ; also 
stimulant, deodorant, disinfectant, and parasiticide. Its effects are 

* V Union Med., Mars. 22d, 1886; Annates d' Oculist, Mai, Juin, Juillet et Aout, 
1886. Dr. Trousseau. 
35 



346 MATERIA MEDICA AND THERAPEUTICS. 

analogous to carbolic acid, and, like that agent, when locally applied it 
produces paralysis of the cutaneous end-organs of the sensory nerves 
(Lewin). Its taste is pungent and slightly caustic. When given 
internally in full doses it produces tinnitus aurium, deafness, reduction 
of temperature, often diarrhoea, and sometimes nausea and vomiting. 
In several cases its ingestion caused violent delirium and collapse; 
profuse diaphoresis took place, and the urine was of a dark green 
color, but free from albumen ; the sweating was not as marked as that 
produced by salicylic acid, nor was the antipyretic effect as great. 

Medicinal Uses. — As an antiseptic in inflammations and ulcera- 
tions of the mouth, as stomatitis, it is very useful, and it has been 
employed as an inhalation (gr. vij to warm water fgj) to diminish the 
expectoration of phthisis, etc. It is one of the best intestinal antisep- 
tics, and may be used in amounts varying from gr. v-x internally in 
abnormal conditions of the intestine attended with putrefactive changes 
in the chyme. Topically, it is used to fulfill the same indications as 
carbolic acid. Da Costa recommends crystallized thymol as a gargle 
in diphtheria. It is employed in ringworm of the scalp, thymol, gr. j, 
alcohol and glycerin, aa (5/4 and water, f§i ; and as a mouth-wash in 
ulcerative stomatitis. 

Administration. — Dose, gr. j-x in pill or capsule; as a spray or 
solution, I to 1000 of warm water; as an ointment, gr. v-5/4 to §i. 

LYSOL (Not Official). 

Preparation and Properties. — This is produced by dissolving 
in fat the fraction of tar-oil that boils between 190 and 200 C, and 
subsequently saponifying it. As thus made, it is a brown, oily-looking, 
clear liquid, of a creosote-like odor. It mixes with water as well as 
glycerin, forming a clear, frothing fluid with the former. Lysol con- 
tains 50 per cent, of cresols, and is substantially the latter rendered 
soluble. 

Effects and Uses. — Lysol is powerfully germicidal, deodorant, 
and non-irritant, soluble and scarcely, if at all, toxic (8 times less than 
carbolic acid, Gerlach). It is likewise cheap. 

Administration. — In aqueous solution, ^ to 4 per cent. 

EUGENOL (Not Official). 

Source and Properties. — This is an aromatic, oily, liquid 
phenol, found in oil of cloves, pimenta, etc. It is soluble in alcohol, 
and forms definite compounds with the caustic alkalies. 



ANTISEPTICS AND ANTIPYRETICS. 547 

Effects and Uses. — Eugenol possesses powerful antiseptic 
power, considered greater than that of carbolic acid. 
Administration. — Dose, Tftxx-xl, in capsules. 

ICTHYOL. 

This substance (not official), first described in 1882 by Schroetter, 
and only recently introduced to the profession, derives its name from 
tyfioci, fish, and ohtov, oil. 

Preparation and Properties. — Its chemistry and action- have 
been carefully described by Egasse * and Charles. f It is procured by 
the dry distillation of a kind of sulphurated bituminous mineral found 
in the Tyrol, which contains fossil- fish, and marine animal remains in 
abundance. By this process an oily substance is obtained, which 
yields on rectification a greenish fluorescent body containing about 10 
per cent, of sulphur (Bauman and Schotten), which when treated with 
H 2 S0 4 and neutralized furnishes a new product. This product com- 
bines readily with the alkalies, as well as zinc, mercury, etc. With 
ammonia it forms an icthyolate, or icthyol, a thick, fluid, stable, fatty- 
looking substance, of a brownish-black color, and of a strong bitu- 
minous taste and smell, readily miscible with oils (except olive), vase- 
line, chloroform, or ether and alcohol mixed, but only slightly so in 
ether, or alcohol alone. It is soluble in water though a resinous de- 
posit goes down on standing. 

Incompatibles. — On account of its reducing properties, it should 
not be mixed with remedies that part readily with oxygen, as potas- 
sium permanganate. 

Aids. — Boric acid, salol, and the tarry preparations. 

Physiological Effects. — Locally; some recent experiments by 
Fessler (loc. cit.), show that icthyol possesses antiseptic and bacteria- 
cidal properties, at least against certain kinds of microbes (streptococ- 
cus pyogenes, and erysipelatis, and the fresh colonies of the diphtheritic 
bacilli); moreover, its power of abstracting oxygen from the tissues 
should place it among the agents that hinder the development of aerial 
pathological germs. It is also ischsemic, sedative and parasiticide. The 
action of icthyol has not yet been completely studied. Its taste is like 



* Bull. Gen. de Therap., 189 1, p. 49. 

f Lancet, London, Sept. 2-6, 189 1. See also " Die Wirkung Icthyols bei Erysipel und 
Vorwandten Krankheiten," Fessler, Miinchen, 1892; also Centralbl. f. Bakt. u. Parasit., 
1893, Band xiv, No. 13. 



548 MATERIA MEDIC A AND THERAPEUTICS. 

that of pitch. When given to dogs, in small quantities (5jj^), it is 
innocuous, but in doses of from §iij-jv, it induces prolonged diarrhoea, 
hence it may be considered in lethal amounts as a gastro-intestinal 
irritant. As to whether it exerts any influence upon the cerebro- 
spinal system and temperature, no observations have been recorded. 
In feeble doses, it manifests a decided contracting influence upon the 
calibre of the arteries, veins and capillaries due, according to Unna, 
but denied by others, to its property of withdrawing oxygen from the 
tissues when brought in contact with them, by which the external coat 
of the vessel is kreatinized, and not to a narrowing of its calibre. In 
large amounts it is stated to bring about an abundant migration of the 
white corpuscles from the vessels. 

Medicinal Uses. — So far the employment of icthyol has been 
almost entirely limited, as a weak antiseptic, to external exhibition 
particularly in dermal therapeutics, as erythema, acne, eczema, and 
herpes zoster. It has, however, been prescribed topically in neuralgia 
of the 5th pair of nerves (a 3 per cent, solution in alcohol and ether), 
and in chilblain. In erythema its employment is advised when there is 
much hypersemia in the form of soap and hot water or perhaps oint- 
ment, and the same measures are suitable to acne used with friction. 
The form of eczema which it seems best suited to is eczema rubrum ; 
for the ordinary acute eczema it is not adapted. It has been applied 
to the inflamed patches of erysipelas. In spite of the favorable reports 
obtained by some practitioners with this remedy it must be admitted 
that it is still on trial, and that frequently disappointment will follow its 
exhibition. 

Thiol (not official) is a new synthetical product closely akin to 
icthyol chemically and therapeutically. It occurs as a thin, brown 
liquid extract, or as a powder. Its advantages over icthyol are these, 
viz., less unpleasant odor, and freedom from irritation and stains upon 
linen. Its action is desiccant and antiseptic. Thiol is employed topi- 
cally in eczematous affections and gynaecology : 1^ Pul. thiol, dried, 5i ; 
pul. starch, §iv. M. S. — A dusting powder; or as a liquid; 3^ Thiol 
liquid, f§j ; glycerin, f 5ix. M. 

Administration. — For internal use the dose of icthyol varies 
for adults from TTLiv-xx or up to f5j, in 24 hours, given in capsule; for 
topical use it may be made up with lanolin or vaseline, 52^ to the oj 
or stronger ; or it may be dissolved in a mixture of alcohol and ether, 
and applied with a brush. An icthyol soap, 5 to 20 per cent., can be 
obtained. 



ANTISEPTICS AND ANTIPYRETICS. 549 

„ DERMATOL.* 

Description and Properties. — This recent addition to the ma- 
teria medica, introduced by Heintz, is bismuth subgallate (not offi- 
cial) [(OH 3 )C 6 H 2 C0 2 Bi(OH 2 )]. It occurs as a fine, odorless, saffron- 
colored powder, unaffected by light or air, and is insoluble in the 
ordinary menstrua. 

Effects and Uses. — Antiseptic virtues are ascribed to this medi- 
cament, and it is stated to be astringent, unirritating, and to possess 
absorbent powers. It is not toxic. A. Flintf reports success with 
dermatol in gr. x doses, after meals, in fermentative dyspepsia with 
flatulence. Dermatol hastens the cicatrization of ulcers and chancroids, 
and satisfactory results are stated to have followed its use as a deodor- 
izing-antiseptic application to balanitis, suppurating buboes, otorrhoea 
and acute eczema. It is a good dusting-powder in moist eczema. 

Administration. — In compressed tablets; dose, gr. v. Grains 35 
have been taken without injury. Topically, in powder, or dermatol 
10, lanolin 20, and vaseline 70 parts ; it mixes well with zinc oxide 
and starch. 

Gallanol \ (not official) is the anilide of gallic acid, prepared by 
boiling this acid with aniline. It occurs in bitter, colorless crystals, 
soluble in alcohol. 

Effects and Uses. — Reducing and anti-fermentative properties 
are ascribed to this new agent, and it is commended as a non-irritant 
substitute for chrysarobin in eczema and psoriasis. 

Administration. — As ointment, gr. xx-5i to Si. 

Alumnol (not official) is the aluminium salt of naphtol-sul- 
phonic acid containing 15 per cent, of sulphur. It is a fine, white 
powder, soluble in water. It is a harmless, antiseptic astringent, ser- 
viceable, when applied pure, to chancres, and diluted, to moist eczemas, 
balanitis, etc. It is employed in solution 5 to 50 per cent. 

ORDER III.— IRRITANTS. 

Irritants are medicines which are employed to produce irritation 
or inflammation of the parts to which they are applied. They may be 
subdivided into Rubefacients, Epispastics, Suppurants, and Escha- 
rotics. Rubefacients are used merely to produce redness of the skin. 

* On Dermatol, see Transactions Mass. Med. Society, 1893. 
f N. Y. Med. J., Oct. 14, 1893. 
% Ther. Monatsh., Sept., 1893. 



550 MATERIA MEDICA AND THERAPEUTICS. 

Epispastics, Vesicants, or Blisters, cause the transudation of a serous 
fluid under the cuticle. Suppurants produce a crop of pustules. 
Escharotics exert a chemical action on the tissues with which they are 
placed in contact, and decompose or destroy them. The action of 
these classes 'varies only in degree — not in kind. 

RUBEFACIENTS. 

Effects and Uses. — Rubefacients are employed: (i) to remove 
congestion and inflammation, (2) to rouse the capillary system in cases 
of local torpor, (3) to relieve pain and spasm, and (4) as stimulants to the 
general system in coma, syncope, asphyxia, etc. They are adapted to 
cases in which a sudden and powerful, but transient action is called 
for ; but they may be employed where a slight and long-continued 
action is desired. In removing congestion and inflammation, rubefa- 
cients act by stimulating the capillary vessels of inflamed parts, there- 
by restoring their tone and elasticity. That they can influence distant 
organs was pointed out by Brown-Sequard, who called attention to the 
fact that when the skin over the kidneys was irritated the renal arteries 
contracted, hence we can understand what important service a rubefa- 
cient, as a mustard-plaster, may render, in conditions of renal hyper- 
emia. They are useful chiefly in the forming stages or in light grades 
of inflammation. They are very serviceable local anodynes when 
applied to painful parts — acting by a substitutive influence. As general 
stimulants, their efficacy in rousing the system depends partly on their 
action on the capillary circulation, and partly on the pain which they 
produce. They are most valuable in the coma or asphyxia resulting 
from poisons, drowning, etc., and are inferior to blisters in the cerebral 
oppression which occurs in fevers, inflammation of the brain, etc. 

Rubefacients are usually applied till pain and redness supervene. 
If kept too long on the skin, many of them will produce vesication and 
even gangrene ; and in cases of coma particularly, caution is required, 
as the patient may not feel them till dangerous inflammation has 
occurred. 

SINAPIS ALBA-WHITE MUSTARD. 
S1NAPIS NIGRA— BLACK MUSTARD. 

Description, Varieties and Habitat. — Mustard seeds are ob- 
tained from two varieties of Sinapis — Brassica nigra, or Black Mus- 
tard, and Brassica alba, or White Mustard {Nat. Ord. Cruciferaej, small 
annual European plants, cultivated in our gardens. B. Nigra has be- 
come naturalized in some parts of the United States. 



IRRITANTS— MUSTARD. 



551 



Properties. — Black mustard seeds are small, globular, of a deep 
brown color externally, and internally yellow. They are inodorous, 
except in powder; and when rubbed with water exhale a very strong, 
pungent smell. White mustard seeds are larger, yellowish externally, 
and of a less pungent taste, owing to the presence of a mucilaginous 
substance in their skin. The powder of both varieties (commonly called 
flour of mustard) is yellow, and is often adulterated with colored wheaten 
flour. Both varieties yield their virtues wholly to water, and very 
slightly to alcohol. 

Chemical Constituents. — Mustard seeds yield, upon pressure, 
3. fixed saponiftable oil, which contains oleic acid and a peculiar acid 

Fig. 54. 




SINAPIS ALBA; A. SEED; B. SEED-POD. 



termed erucic (HC 22 H 41 2 ). From the black seeds a very pungent vola- 
tile oil, containing sulphur, is afterwards obtained by distillation ; it does 
not pre-exist in the seeds, but is the result of the action of water upon a 
pecidiar principle called sinigrin or potassium myronate (C 10 H 18 NS 2 KO 10 ), 
which is split into allyl sulphocyanide (C 3 H 5 CyS), acid potassium sul- 
phate (KHSOJ, and sugar (C 6 H 12 6 ). This oil is colorless or pale 
yellow, rather heavier than water, of a pungent odor and of an acrid, 
burning taste. Allyl sulphocyanide is the principle to which the black 
seeds owe their activity. From the white seeds no volatile oil is 
obtained; but when treated with water they yield an acrid fixed prin- 



552 MATERIA MEDICA AND THERAPEUTICS. 

ciple, which is analogous in properties to the volatile oil of the black 
seeds. // is the result of the reaction of water upon sinalbiii (CsoH^Ng- 
S 2 16 \ a peculiar ingredient of the white seeds, which is decomposed 
into acrinyl sulphocyanide (C 8 H 7 NSO), sinapine sulphate (C 16 H 25 NS0 9 ), 
and sugar (C 6 H 12 6 ). The development of the volatile oil in the black 
seeds, and of the acrid fixed principle in the white seeds, is supposed 
to depend upon the presence of an albuminous constituent called my- 
rosin, which acts the part of a ferment in determining a reaction 
between water and the peculiar principles of the seeds. Myrosin is 
rendered inert by heat, alcohol, and the acids ; and water, of the ordi- 
nary temperature, is therefore the proper menstruum of mustard. 

Effects and Uses. — When applied to the skin it is a rapid and 
powerful local excitant, speedily producing redness and pain, and if 
long continued, vesication and ulceration. Their taste is bitterish, hot, 
and pungent. Mustard is an acrid stimulant. In small quantities it is 
stomachic ; in larger doses it proves emetic ; and in excessive doses it 
will produce gastro-enteric inflammation. Mustard seeds, swallowed 
whole, have been used as a laxative in dyspepsia, in the dose of a tea- 
spoonful once or twice a day, mixed with molasses ; the white seeds 
are preferred ; the practice is, however, of doubtful value, as they may 
become entangled in the appendicula vermiformis. When mustard is 
employed internally, it is chiefly as an emetic, in cases of torpor of the 
stomach, particularly after narcotic poisoning ; and by its stimulant action, 
mustard often arouses the gastric susceptibility when other emetics fail. 

External Uses. — The most general use of mustard is, however, 
as a cutaneous stimulant or rubefacient-poidtice in the form of cataplasm 
(termed a sinapism). This is made by mixing flour of mustard with a 
sufficient quantity of tepid-water to give it proper consistence, and it 
may be diluted with wheat or rye-flour if a weaker effect is desired. 
Sinapisms are used when a speedy and powerful rubefacient effect is 
required. They are applied to the nape of the neck as a counter-irri- 
tant in apoplexy to restore consciousness, to the same region in cerebral 
meningitis during the stage of excitation ; to relieve the pains of muscu- 
lar rheumatism, myalgia, and to the sterno-mastoid muscle in torticollis. 
The early application of a sinapism is a valuable counter-irritant to the 
integument of the throat in croup, acute laryngitis, hoarseness, and to the 
chest in acute bronchitis. In intestinal disorders, as gastro-intestinal 
catarrh, colic, cholera morbus, and cholera, the effects of mustard applied 
to the epigastrium or abdomen, for the purpose of checking vomiting 
and relieving cramp, are most valuable. 



IRRITANTS— OIL OF TURPENTINE. 553 

Mustard diffused through warm water in which the feet and legs 
are soaked is a popular revulsive remedy at the onset of acute nasal 
catarrh, bronchitis, fever, headache with fever, and yellozv fever. In the 
form of a warm sitz-bath in delayed menstruation, taken at the time the 
period is due, it will often reestablish the flow. Sinapisms should be 
kept on till pain and redness are produced, usually from a quarter of an 
hour to an hour, and in cases of insensibility their effects should be 
carefully watched. They are applied spread on linen, and covered with 
gauze to prevent adhesion to the skin. Mustard is the most active and 
at the same time the most easily controlled of the rubefacients ; a mild 
but permanent effect may be kept up by the addition of a teaspoonful 
to a tablespoonful of mustard to a poultice of Indian meal or flaxseed, 
with a tablespoonful or two of capsicum. 

For ready use there is now kept in the shops charta sinapis (inus- 
tard-paper), which is prepared by mixing black mustard (in pow T der) 
with enough solution of gutta-percha to give it a semi-liquid consist- 
ence, and then applying the mixture by a brush to a piece of stiff paper ; 
each square inch contains about gr. vj of mustard. Before being applied to 
the skin it should be dipped for about fifteen seconds in lukewarm water. 

Administration. — The dose of mustard, as an emetic, is from a 
large teaspoonful to a tablespoonful of the bruised seeds or powder. 
Its use in smaller quantity, as a condiment and stimulant of the diges- 
tive organs, is well known. In the form of whey (§ss boiled in milk 
Oj) it has been given as a diuretic in dropsy. 

Oleum sinapis volatile {volatile oil of mustard}, the volatile oil ob- 
tained from black mustard by maceration with water and subsequent 
distillation, possesses the properties of mustard. It is very irritant. It 
is used in making — 

Linimentum sinapis composition (compound liniment of mustard), 
which is composed of volatile oil of mustard (3 parts), fluid extract of 
mezereum (2 parts), camphor (6 parts), castor-oil (15 parts), and alcohol 
(enough to make 100 parts by weight). 

CAPSICUM. 

Capsicum has been previously noticed as an aromatic stimulant 
(see p. 222). It is an efficient rubefacient, useful in rheumatism, low 
fevers, etc. ; the plaster, tincture, or oleo-resin may be used. 

OLEUM TEREBINTHIN.E— OIL OF TURPENTINE. 

The Oil of Turpentine (see index) is a speedy and efficacious rube- 
facient, and sometimes produces a vesicular eruption. It is employed 



554 MATERIA MEDICA AND THERAPEUTICS. 

in low forms of disease attended with coldness of the surface ; as a 
counter-irritant in inflammation; and as a stimulating liniment in rheu- 
matic and paralytic cases. It is often diluted with olive-oil. 

LINIMENTUM AMMONIA-LINIMENT OF AMMONIA. 

This preparation, called also Volatile Liniment, consists of 35 parts 
of water of ammonia (see p. 218, et seq.), alcohol, 5 parts, and 60 parts 
of cotton-seed oil. It is an excellent application, as a counter-irritant, 
in affections of the throat and chest, etc. 

PIX BURGUNDICA— BURGUNDY PITCH. 

Description and Habitat. — This is the prepared resinous exu- 
dation from Abies excelsa, or Norway Spruce [Nat. Ord. Coniferae), 
a lofty, evergreen tree of Europe and northern Asia. 

Preparation and Constituents. — It is obtained by stripping off 
the bark and detaching the flakes of resinous matter which form upon 
the surface of the wound; they are afterwards melted in boiling water 
and strained. Burgundy pitch is collected principally in Germany and 
France, and derives its name from Burgundy, in the latter country. 
After it is imported into the United States it is generally re-melted and 
strained to free it from impurities ; and as found in the shops it is a 
hard, brittle, opaque substance, of a yellowish or brownish-yellow 
color and a weak terebinthinate taste and smell : when applied to the 
body it softens and becomes adhesive. It contains resin and a much 
smaller proportion of volatile oil (C 10 H 16 ) than turpentine. 

A spurious Burgundy pitch is made by melting together pitch, 
resin and turpentine, and agitating the mixture with water. 

Effects and Uses. — This is a gentle rubefacient, producing a 
slight degree of inflammation and serous effusion, without separating 
the cuticle. It occasionally produces a papillary or vesicular erup- 
tion ; and sometimes, though rarely, occasions painful vesication and 
even ulceration. It is employed in the form of plaster to the chest in 
chronic a7id subacute pidmonary disorders, to the loins in lumbago, to 
the articulations in affections of the joints, rheumatic arthritis, and for 
the relief of local rheumatic pains. 

Administration. — Emplastrum Picis Burgundies {Burgundy pitch- 
plaster) consists of 80 parts of Burgundy pitch melted with olive oil 5 
parts and 15 parts of yellow wax, which is used to give consistence to 
the pitch. Emplastrum picis cantharidatum [cantharidal pitch-plaster) 
consists of cerate of cantharides 80 parts and of Burgundy pitch enough 



IRRITANTS— EPISPASTICS. . 555 

to make 1,000 parts ; this is commonly called the warming plaster, 
and is a more active rubefacient than Burgundy pitch, though it does 
not usually blister. It is a useful application in myalgia, pleurodynia, 
lumbago and chronic bronchitis. The iron-plaster and opium-plaster all 
contain Burgundy pitch. 

Many other substances are occasionally employed as rubefacients. 
Ginger {vide p. 226), Black Pepper (vide p. 223), Garlic, Menthol, 
Iodine, Camphor, Chloroform liniment (for which see index) are 
particularly deserving of mention. A gentle counter-irritant, often used 
to the epigastric region to relieve vomiting, is the spice -plaster, which 
is made by mixing §ij of powdered ginger with §j of powdered cloves 
and cinnamon, each, and 5ij of capsicum, adding f§ss of tincture of 
ginger and honey enough for proper consistence. 

EPISPASTICS. 

Epispastics, called also Vesicants and Blisters, are medicines which, 
when applied to the skin, produce inflammation, accompanied by effu- 
sion of serum beneath the cuticle. Many of the rubefacients will 
blister if kept on the skin a sufficient length of time ; and on the 
other hand, the action of vesicants may be made not to extend beyond 
rubefaction. The first effect of a vesicant when applied to the integu- 
ment is to redden the skin, the superficial vessels becoming dilated, 
and a sense of burning is set up in the part. If the irritation be con- 
tinued, serum, plasma and corpuscles begin to ooze from the vessels, 
the epidermis is raised and a vesicle is formed, varying in size accord- 
ing to the extent of the exciting cause. Considerable local pain now 
ensues, and should the irritation be sufficiently severe or prolonged, a 
crop of pustules appears. The inflammation of the skin caused by 
vesicants is erysipelatous in its character, and may result in sloughing 
or gangrene. 

Contraindications. — In inflammation of the dermoid tissues, as 
rubeola and scarlatina, in typhus under certain circumstances, in debili- 
tated conditions of the system and in extreme infancy, vesicants may 
produce serious consequences. 

This class of agents is employed — 1. As local stimulants, in the 
cure of internal inflammations as chronic synovitis, gonorrheal and 
chronic rheumatism, and endocarditis. Different explanations have 
been offered of the antiphlogistic influence of blisters, some therapeu- 
tists ascribing it to a derivative or revellent action, by determining 
vascular and nervous energy to the seat of their operation, but it is 



556 MATERIA MEDICA AND THERAPEUTICS. 

more probably due to a stimulant effect extended to the capillary ves- 
sels of the inflamed organ, and experience has shown that, for the 
relief of internal inflammation, they cannot be applied too near the 
affected organ. In affections of the meninges of the head and spine, 
blisters are serviceable in meningitis, cerebral and spinal, for example. 
2. To substitute a healthy therapeutic inflammatory action, which sub- 
sides spontaneously, for a morbid action existing in the part to which 
they are applied : In this way vesicants are used for the cure of various 
chronic cutaneous eruptions, particularly chronic eczema. 3. To re- 
lieve pain, which they do partly by a stimulant and partly by a substi- 
tutive influence. 4. To stimulate the absorbing or secreting vessels 
of parts contiguous to the seat of their application ; in this way they 
are useful in promoting the absorption of dropsical effusions, as in 
pericarditis. 5. As general stimulants, in coma, syncope, etc. 6. As 
local stimulants, in paralysis, facial palsy, etc. 7. To prepare a sur- 
face for the endermic application of medicines. 

Cajitharidal collodion (formerly collodion cum cantharide) is the 
vesicant usually employed to meet the above indications (p. 560). 

CANTHARIS-CANTHARIDES. 

Description. — Cantharis vesicatoria, termed also Lytta vesica- 
toria, the Spanish Fly {Class, Insecta ; Order, Coleoptera), is a cylin- 
drical insect, from six to ten lines in length by two or three in breadth, 
with a large cornate head, an oblong body, and elytra, or wing-cases, 
of a beautiful, shining, golden-green color. 

Habitat and Collection. — It is found most abundantly in 
wSpain, Italy and the south of France, but occurs in all the temperate 
parts of Europe, and in western Asia. The Spanish flies swarm on 
certain trees and shrubs, and may be detected at a considerable dis- 
tance by their strong fetid odor, which resembles that of mice. They 
make their appearance in May and June, and are collected in these 
months by persons protected by masks and gauntlets, who beat or 
shake them from the trees on which they lodge, and receive them, as 
they fall, upon linen cloths spread underneath. They are plunged 
into hot vinegar and water, or exposed to the vapor of boiling vinegar, 
and are afterwards dried in the sun or by drying-stoves. When per- 
fectly dry they are packed in canisters, which are carefully closed so 
as to exclude air and moisture. They are usually imported into this 
country from some Mediterranean port. A highly-esteemed variety 
comes from south Russia, through St. Petersburg, which is distin- 
guished by the large size and copper-color of the flies. 



IRRITANTS— CANTHARIDES. 557 

Properties. — In the dried state, cantharides retain their form, 
color, odor, etc.; their taste is acrid, burning and urinous; their 
powder is of a grayish-brown color, interspersed with shining green 
particles. If exposed to moisture they are soon decomposed, most 
speedily when powdered. As, moreover, the powder is liable to 
adulterations, they should be always purchased whole, and should be 
powdered as they are wanted for use. They are liable to be attacked 
by mites, which destroy the interior soft parts : the best mode of pre- 
serving them is to expose them, in bottles, to the heat of boiling water, 
which destroys the eggs of the insect. A little camphor or ammo- 
nium carbonate, or a few drops of acetic acid or of chloroform, added 
to the flies, are also recommended as preservatives. 

Chemical Constituents. — The most important constituents of 
cantharides are a volatile oil, upon which the odor depends, and a 
neutral crystalline substance, termed cantharidin (C 10 H 12 O 4 ), which 
is the vesicating principle. Cantharidin is inodorous, tasteless, soluble 

Fig. 55. 




CANTHARIS VESICATORIA. 



in ether, chloroform, the oils, acetic acid, and boiling alcohol, and 
nearly insoluble in cold water and alcohol ; but notwithstanding the in- 
solubility of cantharidin, watery and alcoholic solutions of cantharides 
possess the medicinal properties of the insect, — the cantharidin being 
rendered soluble by combination with a yellow coloring matter in the 
insect. By the aid of heat, in the presence of water, cantharidin may 
be made to combine with the alkalies, being converted into can- 
tharidic acid. 

Aids. — Internally, as an aphrodisiac, by phosphorus, and strychnia; 
topically, the vesicants, as aqua ammoniae fortior, sinapis, etc. 

Contraindications. — Acute renal inflammation ; in debilitated 
subjects blisters may excite sloughs ; applied to the recumbent parts 



558 MATERIA MEDIC A AND THERAPEUTICS. 

of bed-ridden people there is danger of making bed-sores ; or to high 
inflammation about a joint. 

Physiological Effects. — The activity of cantharis depends on 
the presence of cantharidin. Applied to the skin, cantharides produce 
inflammation which terminates, if the application is prolonged, in the 
secretion of serum under the cuticle in the form of vesicles which 
unite to make in 7 to 10 hours a large bulla. Even when they are 
externally applied, their constitutional effects, as strangury, tenesmus, 
etc., are frequently manifested. Cantharides are an acrid stimulant. 
Taken internally they irritate the mouth and fauces, and reaching the 
stomach they produce a sensation of heat and gastrodynia, all more or 
less emphasized according to the amount swallowed. Cantharidin 
rapidly passes into the blood, augmenting the secretion of the kidneys, 
and in large amounts produces irritation of the genito-urinary pas- 
sages, which is evinced by strangury, priapism, pain and occasionally 
the discharge of bloody urine. Erotic excitement does not, however, 
always follow the ingestion of cantharides. Palle * has recorded his 
observations on this point, obtained by questioning a number of men 
who had taken the drug, and in none was amatory desire present. 
Christison affirms the same thing, while Pereiraf holds to the contrary. 
It would seem most probable that only small doses are likely to prove 
aphrodisiac, large ones being too violent to admit of such action. In full 
doses cantharides excite the heart and quicken the pulse and respiration. 
GalippeJ found that when injected into animals, the chief symptoms 
were dysuria, haematuria, vomiting, dilatation of the pupil, enfeebling of 
the general sensibility, collapse and death. The chief post-mortem 
lesions were inflammation of the digestive tube, kidneys, and bladder. 

Toxicology and Antidotes. — In large doses they produce vio- 
lent gastro-enteric, and genito-urinary inflammation ; and in excessive 
doses prove fatal, with convulsions, tetanus, delirium and other cerebro- 
spinal symptoms. Twenty-four grains § have caused death, while 
recovery has followed || the swallowing of f5yj of the tincture. In 
cases of poisoning, after the stomach has been emptied, opiates, 
demulcents and stimulants are to be resorted to, but oils are to be 
avoided, as cantharidin is soluble in this menstruum. 

* Journ. de Pharm. et de Chimie, 13, 1871, p. 43I. 

I "Mat. Medica.," Vol. it. 

% Gaz. Hebdom., 1874, 2d ser., p. 438. 

\ Taylor's Med. Jurisprudence, I, 1 883, p. 350. 

|| Ibidem. 






IRRITANTS— CANTHARIDES. 559 

Medicinal Uses. — The indications which cantharides are capable 
of fulfilling, when administered internally as a diuretic, emmenagogue, 
etc., have been already noticed (see p. 399). Their chief use is as a 
topical application to produce blisters (see Epispastics) ; but they are 
sometimes employed also externally as rubefacients, for' the purpose of 
local or general stimulation in low forms of disease. Blisters are par- 
ticularly serviceable in obstinate neuralgia, lumbago and sciatica, and 
should be applied over the nerve or part involved. Blistering the 
praecordium during the effusion of pericarditis will often dispel the 
fluid, and this measure over the spinous vertebral processes at the 
nape of the neck is serviceable in meningeal inflammation of either 
cord or brain. As a counter-irritant a blister is of some value in 
spermatorrhoea, applied to the perineum. Cantharides are preferred to 
all other substances as epispastics, and they are used for all medicinal 
purposes that are within the range of this class of medicines. 

The following are the forms under which Spanish flies are used 
externally : — 

Ceratum cantharides (cantharides cerate), commonly known as 
blistering cerate , is composed of cantharides (32 parts), melted wax and 
resin (each 18 parts), lard (22 parts), and turpentine oil (10 parts). This 
is the preparation usually employed to raise a blister. It can be applied 
without the aid of heat, and should be spread on soft leather, or linen, 
or adhesive plaster, and covered with gauze or unsized paper. From 
four to twelve hours is the period for which the cerate should be 
applied ; on the scalp a longer application may be required. For an 
ordinary impression, and where the cutaneous sensibility is not 
impaired by disease, it need not be kept on more than four or five 
hours. In cases of children less time is required for the application of 
the cerate, and great caution is necessary in applying it to infants. A 
poultice of bread and milk or flaxseed meal should be afterwards 
applied, which usually produces vesication if the action of the blister 
has not extended beyond rubefaction. If it be desirable to heal the 
blistered surface immediately, cotton-wadding or cerate may be placed 
over it, after the serum has been allowed to escape, the blebs being 
punctured at their most dependent points. To maintain the discharge 
the cuticle should be removed and basilicon ointment applied ; if the 
surface require further irritation, the ointments of savine, mezereon, 
or cantharides may be used. The open or perpetual blister is, how- 
ever, not required for ordinary antiphlogistic purposes ; and indeed, as 
a general rule, the blistered surface should be allowed to heal as 



560 MATERIA MEDIC A AND THERAPEUTICS. 

speedily as possible. In cases of excessive pain a poultice of bread- 
crumb and lead-water, with morphine sulphate gr. ^ mixed in it, or a 
starch-poultice or lime-liniment, is a soothing application. Goulard's 
cerate is an excellent application to heal obstinate ulcers from blisters. 
For the relief of strangury, diluents and diuretics are proper, as flax- 
seed tea with sweet spirit of nitre, decoction of uva ursi, etc., and an 
opium or morphine suppository if the symptoms are severe. Blisters 
should not be applied directly over an inflamed part, as they may 
increase capillary dilatation and the pain, where the skin is loose, over 
bony prominences, or to the mammary glands in pregnancy. The 
danger of strangury should also be borne in mind. A thin piece of 
silver-paper, or camphor sprinkled on the blister, is said to prevent 
this effect. Ethereal, alcoholic, hydro-alcoholic and watery extracts 
of cantharides have been suggested as substitutes for the blistering 

Fig. 56. 




CANTHARIS VITTATA. 
« 

cerate, and, mixed with wax and spread on thin cloth or paper, are 
termed vesicating taffetas. Collodium cantliaridatnm (cantharidal 
collodion), is made by percolating cantharides with chloroform, until the 
cantharides are exhausted, evaporating the liquid thus obtained, and 
dissolving the residue in flexible collodion. It should be kept in a 
cool place. It furnishes a very convenient mode of blistering a small 
irregular surface, and is applied by means of a camel's-hair brush, in 
successive layers, which should be covered with a piece of oiled silk. 
Applied to the glans penis it will prevent masturbation during the 
existence of the bleb. The cantharidal preparations are used, applied 
to the bald patches, to promote the growth of the hair, in functional 
alopecia, and to destroy the tinea of ringzvor/n. They are, too, applied 
to the diseased skin prior to the application of a tineacide. Duptiy- 
treris pomatum is a tincture made with cantharides, 5j, and alcohol, 
fgj, incorporated with nine parts of lard. 

Cantharis Vittata {Potato- flies) (not official). — Several species of 



IRRITANTS— ESCHAR O TICS. 561 

cantharis are found in the United States, and are good substitutes for 
C. vesicatoria. C. vittata, or the Potato-fly, is most used. It resembles 
the Spanish fly in shape, but is rather smaller, being about six lines 
in length, with black elytra or wing-cases, and inhabits chiefly the 
potato-plant. It contains cantharidin. 

AQUA AMMONLE FORTIOR-STRONGER WATER OF AMMONIA. 

Stronger Water of Ammonia {vide p. 218) may be used for the 
purpose of speedy vesication. It is more rapid, but much more painful 
than cantharides. Five parts of this, mixed with spirit of camphor, 
2 parts, and spirit of rosemary, 1 part, has been used as a prompt vesi- 
cant under the name of Granville 's Lotion. A piece of flannel, saturated 
with the liniment is applied to the skin, which it will generally blister 
in from three to ten minutes. Gondrefs Vesicating Ointment is made 
by melting together 2 parts of expressed oil of almonds and 32 parts 
of lard, and adding to this mixture 17 parts of stronger water of am- 
monia ; it will vesicate in ten minutes. Ammonia is applied topically 
as an antidote to the poison of venomous reptiles and insects. Mezereum 
also vesicates (p. 384). 

SUPPURANTS. 

OLEUM TIGLII-CROTON OIL. 

Croton Oil {vide 373), when rubbed on the skin, produces rube- 
faction, accompanied by a pustular eruption. It is used as an applica- 
tion to the skin of the throat and chest in subacute, or chronic laryngeal 
and bronchial affections, hoarseness, and to rheumatic joints, and rheu- 
matic arthritis. It may be applied undiluted or mixed with one, two 
or three parts of olive oil, or oil of turpentine, according to the suscep- 
tibility of the skin. 

UNGUENTUM ANTIMONII— ANTIMONIAL OINTMENT. 

This ointment consists of 1 part of antimonium and potassium 
tartrate mixed with 4 parts of lard. The peculiar eruptive effects of 
tartar emetic have been already noticed (see p. 250). It may be used 
in the form of ointment or solution in the same cases as croton-oil, 
but it is a more painful and permanent application. It is not official. 

ESCHAROTICS. 

Escharotics (from ioyapa, an eschar) called also Cauterants, are 
medicines which destroy the structure and vitality of the parts to 
which they are applied. The eschar which their application produces 
36 



562 MATERIA MEDICA AND THERAPEUTICS. 

is followed by inflammation and suppuration of the surrounding 
tissues, by which the slough is separated from the living parts. 

They are employed — I. To effect the destruction or removal of 
morbid growths, warts, condylomata, polypi, fungous granulations, lupus, 
etc. 2. To destroy the virus of rabid and venomous animals, and of 
chancres and malignant pustules, and to prevent their absorption. 
3. For the cure of violent inflammation by their substitutive action, as 
when they are applied to the mucous or cutaneous surfaces in gonor- 
rheal ophthalmia, erysipelas, poisoned parts, carbuncles, etc. 4. To 
stimulate indolent sinuses, ulcers, etc., where their influence is also of 
a substitutive character. 

ARGENTI NITRAS FUSUS— FUSED SILVER NITRATE. 

Lunar Caustic (described at p. 204) is the most commonly em- 
ployed of the caustics. It has the advantage of not liquefying when 
applied, and its action is therefore confined to the parts with which it 
is brought in contact, and is superficial. 

Medicinal Uses. — It is used to remove the fungous granidations 
of wounds and ulcers, to destroy warts, to alter the action of indolent 
ulcers, sinuses, and fistidce, to subdue the inflammatory action of par- 
onychia, erythema, etc. ; to arrest the progress of cancrum oris, to cure 
skin-diseases by a substitutive action, and in inflammations of mucous 
membranes. In dilutions of various strengths it is resorted to in every 
variety of inflammation of the mucous membranes ; when a full im- 
pression is desired, a solution of gr. xx— xxx in distilled water f 5j may 
be employed ; for ordinary purposes, gr. ij-v to water f§j. The diluted 
silver nitrate (vide p. 204) is also used topically. 

POTASSA. 

Preparation and Properties. — Caustic Potassa (KHO) is pre- 
pared by the rapid evaporation of Solution of potassa {vide p. 485) with 
heat. While in the state of fusion it is received into cylindrical iron- 
moulds, and it occurs in the form of sticks of a brownish, grayish or 
bluish color, of a fibrous fracture, the odor of slaking lime, and a 
caustic, urinous taste. It dissolves in alcohol and in less than its 
weight of water, and attracts both moisture and carbonic acid rapidly 
from the air. It is more or less impure as found in the shops. By 
digestion in alcohol it is freed from impurities insoluble in this men- 
struum (as the potassium carbonates), and it may be afterwards obtained 
quite white and pure by evaporation; it is then termed alcoholic potassa. 



IRRITANTS— SODA. 563 

Effects and Uses. — It is one of the most powerful known 
escharotics, differing from lunar caustic in extending its action to a 
considerable depth beneath the surface to which it is applied. It acts 
by absorbing the water of a part and converting it into a slough, and 
to a certain extent by saponifying the tissues. It is used chiefly to 
form issues, to destroy the virus of malignant pustules, and that from 
the bites of venomous reptiles and rabid animals, and sometimes also to 
arrest the sloughing of carbuncles, and, from its deep-reaching action, 
it is preferred to lunar caustic in these cases ; applied to the cutaneous 
surface, in cases of threatened abscess, carbuncle, etc., it will sometimes 
avert the progress of the inflammation. It is a good application in 
cases of rodent idcer, the superficial forms of epithelioma generally, and 
in lupus, the diseased tissue having been removed with a knife as thor- 
oughly as possible previous to the application of the caustic. When 
it is applied to the skin, this should be covered with linen spread with 
adhesive plaster, having a hole the size of the spot to be cauterized, 
and the caustic wrapped in paper, or supported on a holder. A solu- 
tion (5jss to f §ij of water) is used as a rubefacient. Being extremely 
diffusive in action, as well as painful, its uses are limited. After appli- 
cation dilute acetic acid checks its action. 

Potassa cum Calce {Potassa with Lime) is prepared by rubbing up 
equal parts of potassa and lime. It is a grayish-white powder, which 
is sometimes made into a paste with a little alcohol, and is termed 
Vienna Paste ; it has been also formed into sticks. The presence of 
lime renders this a milder, less deliquescent and more manageable 
caustic than potassa ; it is a favorite application to ncevi and rodent idcer. 

SODA. 

Preparation and Properties. — Caustic 6W^(NaHO) is prepared 
by the rapid evaporation of Solution of soda (vide p. 487) until ebulli- 
tion ceases and the soda melts ; when it has congealed, it is broken 
into grayish-white, opaque, brittle fragments, which are very corrosive, 
very soluble in water, soluble in alcohol, and deliquescent, though, 
unlike potassa, it does not become permanently liquid, but after a 
time effloresces. 

Effects and Uses. — It is employed for the same cauterant pur- 
poses as potassa, than which it is somewhat milder in action. London 
Paste is made by rubbing up equal parts of soda and lime. 

ACIDUM CHROMICUM— CHROMIC ACID (CHROMIC ANHYDRIDE). 

Preparation and Properties. — Chromic Acid (CrO s ) is obtained 
by the reaction of sulphuric acid upon a solution of potassium bichro- 



564 MATERIA MEDICA AND THERAPEUTICS. 

mate. It is properly chromic anhydride, and occurs in the form of 
anhydrous, deep-red, needleform crystals, of an acid, metallic taste ; 
they are deliquescent and very soluble in water, with which they form 
an orange-yellow solution. 

Incompatibles. — Chromic acid is incompatible with organic mat- 
ter ; it must not be mixed with glycerin, alcohol, tannic acid, sugar, 
etc., as decomposition and explosion may ensue. 

Effects and Uses. — This is an escharotic of great power, decom- 
posing the tissues by its rapid oxidizing action and staining them 
blackish-brown. Used in the form of paste, or solution more or less 
diluted, it is a most efficacious application to lupus, morbid growths 
and excrescences, etc., and is unequalled as an agent for removing warts 
from the hands. It gives less pain than other caustics ; but it is to be 
used with caution, especially near delicate parts like the eye, as its 
action is deeply penetrating. A 5 per cent, solution of chromic acid 
will check the fetor of sweating of the feet, but the skin must not be 
broken. 

Administration. — The solution may be made of the strength of 
from gr. 100-oj to foj of water, and is to be applied by means of a 
pencil or glass rod. 

ACIDUM ARSENOSUM— ARSENOUS ACID. 

This is a powerful escharotic (vide p. 469), and is occasionally ap- 
plied in lupus, onychia maligna, cancerous ulcers, and to change the 
action of indolent sinuses ; but its use is attended with danger. When 
used, it should be applied freely, as a large amount causes such rapid 
death of the tissues that absorption is rendered impossible. It may be 
diluted with one or more parts of sulphur. 

BROMUM— BROMINE. 

Preparation, Properties and Tests. — Bromine (Br) is an ele- 
mentary body, bearing close chemical affinities to iodine. It is a 
constituent of sea-water and of many mineral springs. It is a volatile, 
dark-red liquid (sp. gr. 3), of a caustic taste and a strong, disagreeable 
smell, sparingly soluble in water, more soluble in alcohol, and still 
more so in ether. Tests. — With starch-paste it yields a yellow color ; 
with silver nitrate, a yellowish-white precipitate. 

Physiological Effects. — The action of bromine on the system 
considered chemically is very similar to that of chlorine. It decom- 
poses hydrogen compounds, forming hydrobromic acid, and separating 



IRRITANTS— PO TASSIUM BICHR OMA TE. 565 

the elements combined with the hydrogen ; hence it is a deodorant 
and disinfectant. On account of these properties, and because it is a 
liquid, it is a severe, rapid and thorough caustic. The vapor is in- 
tensely irritant to the mucous membrane, causing, when inhaled in 
sufficient quantity, laryngitis, bronchitis and pneumonia. 

Toxicology. — In the stomach it is a corrosive poison. Snell * 
reports a case in which oj killed an adult in seven hours. The symp- 
toms were immediate dyspnoea, epigastric pains, trembling of the 
hands and great anxiety. 

Medicinal Uses. — It is never employed internally. In chronic 
nasal catarrh, ozcena, and hay-fever, a small quantity of a solution 
(5ss) in alcohol (fojv) may be inhaled from a wide-mouthed vial with 
good results. 

Topically, in hospital gangrene, after removing the slough, it is 
one of the best escharotics. It is also used as a caustic in phagcedena, 
and various forms of cancer, especially cancer of the uterus. 

ZINCI CHLORIDUM— ZINC CHLORIDE. 

This is also a powerful escharotic {vide p. 200) ; and in addition 
to its corrosive properties, it appears to exercise a greater influence 
over the vital action of neighboring parts than some other caustics. 
The separation of its eschar leaves very healthy and vigorous granu- 
lations, and it is one of the best applications that can be made to 
intractable indolent idcers and sinuses. It will sometimes cure lupus. 

LIQUOR HYDRARGYRI NITRATIS— SOLUTION OF MERCURIC NITRATE. 

This preparation (vide p. 457), termed also the acid nitrate of 
mercury, is a valuable caustic application to malignant ulcers, hospital 
gangrene, chancre, etc. 

HYDRARGYRI CHLORIDUM CORROSIVUM— CORROSIVE CHLORIDE OF MERCURY. 

Corrosive Sublimate is more frequently used as an antiseptic wash 
than as a caustic (see p. 45 1). 

POTASSII BICHROMAS-POTASSIUM BICHROMATE. 

This salt, already noticed under the head of Alteratives (vide 
index), is a good caustic application, in saturated solution or in 
powder, to syphilitic and other vegetations. 

* N. Y. Journ. of Med., 1850, p. 179. 



566 MATERIA MEDIC A AND THERAPEUTICS. 

ACIDA MINERALIA-MINERAL ACIDS. 

The mineral acids (vide p. 169) are powerful escharotics, but are 
inconvenient for many uses, on account of the extension of their action 
beyond the point of application. On the other hand they can be made 
to reach the bottom of sinuses and fistula, which are inaccessible to 
the solid caustics. Nitric acid, for such purposes, has no equal in the 
list of escharotics ; it is also used to destroy warts. It stains the 
tissues yellow. Properly diluted, the mineral acids are employed in 
injections, gargles, etc.; and in the form of ointment, in skin-diseases. 

Copper Sulphate {vide p. 197) and Alum (vide p. 207) are mild 
escharotics, but are used chiefly to remove fungous granulations in 
ulcers, as a mild cauterant to the granulations of ophthalmia, to mucous 
patches, etc. The actual cautery has been alluded to under the head 
of Heat (vide p. 34). 

Under " Irritants " may be considered sapo viridis, chrysarobin, 
hard and soft soap, remedies which, although not used as escharotics, 
are applied to the skin in certain of its diseases for their local irritant 
and cleansing effects. Soft soap (sapo mollis) is employed officially as 
a liniment (linimentum saponis mollis) which is prepared with soft soap, 
oil of lavender flowers, alcohol and water. Sapo (white castile soap) is 
prepared from soda and olive-oil. For emplastrum saponis, see plumbi 
oxidum, and linimentum saponis, see camphor. 

Hard Soap, sapo durus (not official), sodium oleate, made with 
soda and olive-oil, and soft soap (sapo mollis), potassium oleate, pre- 
pared with potassa and olive-oil, are the common soaps of every-day 
life. Both are detergent. Unna's s:>aps are superfatted with an excess 
of 4 per cent, of olive-oil. Soaps impregnated with various remedies 
are used as a means of bringing in contact with the skin certain drugs 
as tar, creosote, icthyol, etc., in dermatological practice. They are 
termed medicated soaps. Soap is used in pharmacy, and with warm 
water as an enema in constipation. 

Sapo Viridis (not official) — Green Soap — is a soft, greenish, alka- 
line, jelly-like soap, prepared from potassa and the fish-oils, very 
soluble in water and alcohol. Like all soaps, especially soft soaps, it 
is a mild caustic, and was introduced into medical practice by Professor 
Von Hebra, in the treatment of various cutaneous affections, especially 
of the scaly variety. 



IRRITANTS— CUR YSAR OBINUM. 567 

Medicinal Uses. — Locally, green soap is solvent, detergent and 
feebly parasiticidal. It is useful to remove the infiltrated patches of 
the various forms of chronic eczema, and for this purpose should be 
well rubbed in with a piece of flannel until all traces of the soap have 
disappeared, when the flannel is wet with water and the rubbing again 
performed ; the surface should be then washed with clean water and 
carefully dried, when it will be found red and angry-looking, with 
here and there a minute point from which serum is oozing. Between 
the applications ointments are to be applied. Sapo viridis is also 
much used to get rid of scales and crusts, in psoriasis, phthiriasis, 
and in various other skin-affections. As a local stimulant in alopecia, 
the following makes a serviceable lotion : saponis viridis, §ij ; alcohol, 
Sj. M. S. — Dissolve with heat and filter; apply as a shampoo. Green 
soap is also applicable to the removal of freckles, to cleanse the toes of 
sebaceous matter in fetor of the feet, and to prevent further friction 
about chafed parts. In tinea versicolor it will often effect a prompt 
cure, and it is highly useful to cleanse the skin in parasitic affections, 
as tinea circinata, before the application of a germicide. In the treat- 
ment of comedones (blackheads), Von Hebra rubs in green soap oi%, 
spirit of lavender f5ijss and alcohol fSijss, previously cleansing the 
parts with borax (q. v.). 

Administration. — Tinctura saponis viridis (tincture of green 
soap), no longer official, consists of 65 per cent, of green soap and 2 
per cent, of oil of lavender dissolved in alcohol. It is milder in its 
action than green soap, and is used to fulfill the same indications. 

Chrysarobinum — Chrysarobin. 

Source and Properties. — This, often improperly called Chryso- 
phanic Acid, consists of a neutral principle extracted from ararobd 
or goa-powder, a substance found in the clefts of Andira araroba [Nat. 
Ord. Leguminosae). It has also been obtained from different species 
of rhubarb. It is an orange-yellow powder, turning brown on expo- 
sure to air, crystallizing in needles, insoluble in water, more freely 
soluble in alcohol and chloroform, readily so in ether, and possesses 
neither taste nor smell. 

Physiological Effects. — When applied locally, it is an irritant 
to the skin, staining it yellow, and causing, in excess, irritation and 
inflammation, accompanied by swelling, itching, pain, heat, and some- 
times a papular eruption, especially when in contact with the skin 
about the head and face. The action is not always limited to the part 



568 MATERIA MEDICA AND THERAPEUTICS. 

to which it is applied, but extends to the healthy skin in the vicinity. 
Observers do not agree respecting the internal effects of this drug. 

Medicinal Uses. — It is principally used as an external applica- 
tion in cases of skin-disease due to vegetable parasites as favus, the 
different forms of tinea, etc., for which it is an excellent remedy, and 
in psoriasis, in which disease the scabs soon disappear and the patches 
become white under its use. In the treatment of ringworm the parts 
should first be cleansed with sapo viridis in order to facilitate contact 
of the remedy with the parasite, and then the following solution should 
be applied: 1^ Chrysarobini, gr. v-x; chloroformi, fgj. M. S. — Shake 
before using. After this is dry, liquor gutta-perchae may be painted 
on as a protective, or a bit of rubber-plaster applied for the same pur- 
pose. The solution of chrysarobin should be applied every few days 
until the parasite is effectually destroyed. Alexander * reports excel- 
lent results in sixty cases of ringworm of the scalp from the use of a 
10 per cent, solution of chrysarobin in gutta-percha solution. It must 
not be forgotten that chrysarobin produces a permanent stain upon 
clothing, ivory, etc. It should be applied to the head or face with 
caution on account of the liability to swelling and oedema of the eye- 
lids. It is never used internally. 

Administration. — The ointment {iinguenlum chrysarobini) (made 
by rubbing 5 parts of chrysarobin with 95 parts of benzoinated lard) 
may be used. 

PYROGALLOL. 

Description, Source and Properties. — "A triatomic phenol 
obtained chiefly by the dry distillation of gallic acid," U. S. P., 1890. 
It occurs in white, shining needles or laminae, becoming darker on 
exposure to light or air. It is soluble in water, alcohol and ether. 

Incompatibles. — In solution with the alkalies it absorbs oxygen, 
acquiring a brown color ; in aqueous solution it reduces the silver and 
mercury salts. 

Physiological Effects. — Locally, if concentrated it is irritant 
and toxic, and when thus employed has destroyed human life,f (over 
5i) with diarrhoea, rigor, vomiting and collapse. Its taste is very bitter ; 
so much as gr. v-x have been safely taken. It causes great destruction 
of the red blood-corpuscles, the blood becoming blackish. The post- 
mortem lesions resemble those of phosphorus. 



* Jonrn. of Cutaneous and Venereal Diseases, 1885, p. 
f "Nat. Dispensatory," 5th ed. 



DEMULCENTS. 569 

Medicinal Uses. — Jarisch reports fair results from the local 
application of pyrogallol in 200 cases of psoriasis. 

Administration. — In vaseline or lard 10 per cent., or in flexible 
collodion gr. xx-xl to the ounce. It stains the skin and clothing, and 
must be preserved in amber-colored bottles. 

ORDER III.— DEMULCENTS. 

Demulcents, or Lenitives, are medicines which soften and relax the 
tissues, and when applied to irritated or inflamed surfaces, diminish 
heat, tension and pain. They consist chiefly of gum or mucilage, or 
a mixture of these with saccharine and farinaceous substances, and 
form with water viscid solutions. Their constitutional effects are prin- 
cipally nutritive, though perhaps, to some extent, they relieve irritation 
in distant organs by modifying the acridity of the secretions. 

Demulcent solutions are administered internally — I. To sheathe 
and protect the gastro-enteric surface from the injurious effects of 
irritating substances, particularly acrid poisons. 2. To relieve irrita- 
tion and inflammation of the alimentary canal, as in gastritis, enteritis, 
diarrhoea and dysentery ; and for this purpose they may be adminis- 
tered by either the mouth or rectum. 3. In catarrhal affections, in 
which they are probably useful in part by the transmission of their 
lubricating and soothing effects on the fauces and oesophagus by reflex 
action to the laryngeal and bronchial membranes, and in part by modi- 
fying the acridity of the expectorated matters. 4. In affections of the 
urinary passages, as strangury, cystitis, etc., and in these cases they act 
chiefly by diminishing the acridity of the secretions. 5. As agreeable 
drinks, to quench thirst and promote the action of the secreting and 
exhaling organs in febrile affections. Their effects in these cases are 
owing partly to the water which they contain, to which they are added 
merely for the sake of flavor, and partly also to the nutriment which 
they furnish. When administered with the object of increasing the 
proportion of the fluid parts of the blood, demulcents are termed 
Diluents. 6. As light diet for the sick. 7. For pharmaceutical pur- 
poses, to suspend substances insoluble in water, etc. Topically, mucil- 
aginous solutions are employed extensively to relieve the {a) heat, 
swelling and pain of inflammation, wounds, burns, etc. ; (b) to hasten 
suppuration where inflammation is too far advanced for resolution ; 
(c) to cleanse foul and scabby ulcers and to remove the crusts in skin- 
diseases, as chronic eczema, favus, etc. When applied externally, this 
class of medicines is termed emollients. Mucilaginous and amylaceous 



570 MATERIA MEDICA AND THERAPEUTICS. 

substances are applied to inflamed and ulcerated parts, mixed with 
water so as to form soft masses, termed — 

Cataplasms or Poultices. — PHYSIOLOGICAL EFFECTS. — These are 
useful vehicles for the application of heat and moisture. (For linseed 
poultice see p. 575). When applied to a healthy part a poultice acts as 
a sedative and relaxant. In the early stages of inflammation it lessens 
the amount of blood at the seat of morbid action, by dilating the cuta- 
neous vessels, and prevents stasis and the migration of the white cor- 
puscles ; after stasis has taken place and migration has commenced, it 
favors the formation of pus, probably by aiding migration through the 
relaxing effect it exerts on the walls of the vessels, and also by pro- 
moting cell-proliferation : applied to a wound, it stimulates the forma- 
tion of embryonic and granulation-tissue, from its influence over cell- 
proliferation. If the use of poultices be too long persisted in, the part 
becomes pale, sodden, relaxed and shrivelled and even devitalized, in 
extreme cases. 

Medicinal Uses. — Poultices are used in the early stages of acute 
inflammation of internal viscera for their antiphlogistic effects : thus the 
abdomen may be covered with a large poultice in the early stages of 
peritonitis, if not objectionable on account of its weight, and a jacket- 
poultice may be used with excellent effect in the early stages of p7ieu- 
monia or pleuritis, the chest being completely surrounded by the 
poultice. They are likewise applied to the right iliac region early in 
typhlitis. They are sometimes used for the same purposes in external 
inflammations, as to the orbit in the acute stage of keratitis. For their 
effects on pus-formation and cell-proliferation, and as they soften the 
skin, relax the cuticle, thus lessening tension and pain, they are useful 
in external inflammation when suppuration can no longer be prevented, 
as in boils, carbuncles, disease of the bursa, abscess, paronychia, felon, 
and they are applied to the cheek in cancrum oris. Poultices soften and 
detach the crusts of eczema and sycosis. As they stimulate the granu- 
lation-process, their application should be discontinued as soon as the 
granulations reach the level of the surrounding skin ; for this purpose 
they are applied to chronic ulcers. During the day, poultices should 
be changed every three hours; at night, every four hours. 

When applied to a granulating surface, or indeed, to an open 
wound of any kind, the poultice should be thoroughly antisepticised, 
by admixture with a solution of corrosive sublimate, else it forms an 
excellent nidus for the development of various forms of protophytes, 
the multiplication of which will be accelerated by the heat and moisture. 



DEMUL CENTS— WA TER. 571 

In the treatment of gangrenous, sloughing or foul- smelling ulcers 
or wounds, yeast or charcoal is often added to the poultice to aid in the 
separation of the slough or to correct the fetor. The charcoal-poidtice 
contains wood-charcoal, oj4', bread-crumb, §ij ; linseed-meal, §j^ ; 
boiling water, fox. Mix, adding the meal gradually. The yeast-poultice 
consists of beer-yeast, fgvj ; wheat-flour, §xjv; water at ioo° F., fSyj. 
Mix the yeast with the water and stir in the flour. Poultices may be 
medicated with lead-water and laudanum, or other substances, if it is 
desired to abate the inflammatory process. The laudanum- poultice is 
an efficient anodyne in synovitis, to alleviate the pain of superficial 
inflammation, and it is enveloped about the joints of acute and gonor- 
rhoeal rheumatism for similar purposes. For the rubefacient-poidtice 
see p. 552. 

AQUA— WATER. 

Water has important medicinal as well as pharmaceutical uses. 
The Pharmacopoeia directs it to be employed in the purest attainable 
state. For pharmaceutical purposes, the U. S. P. directs distilled water 
(aqua destillatd) should be used. Pure water is a transparent liquid, 
without color, taste or smell ; but owing to its extensive solvent powers, 
in the natural state it is more or less contaminated with foreign matters. 
It is a compound by volume of 2 atoms of hydrogen and 1 of oxygen 
(H,0). 

Effects and Uses. — Water is necessary for the solution and diges- 
tion of our food; in either insufficient or excessive amount it may 
prove injurious. Thus, without a proper supply of water, not only the 
absorption of soluble matters in the stomach is interfered with, but 
also the passage of undigested substances into the intestines ; and in 
the absence of water some articles, as sugar, do not undergo the fermen- 
tation necessary for digestion. When freely swallowed it softens the 
faeces, renders the blood temporarily more fluid, and increases glandu- 
lar-secretion. On the other hand, an excess of water taken into the 
stomach impairs digestion by over-dilution of the gastric juice, and 
may occasion the acetous fermentation of saccharine articles. Water is 
eliminated from the system by the intestines, skin and lungs, but chiefly 
by the kidneys ; and it is believed, in large amounts, to increase not 
only the water, but the solid constituents, of the urine ; hence its use 
as a diuretic. It materially augments the perspiration, particularly when 
taken warm, and is consequently of great value as a diaphoretic. As 
it promotes both the metamorphosis and construction of tissue, it may 
produce a valuable alterative effect in morbid taints of the system, and 



572 MATERIA MEDIC A AND THERAPEUTICS. 

prove a useful adjunct to more active eliminative agents. Water is the 
basis of all drinks administered to relieve the thirst of fever and mode- 
rate the undue viscidity of the blood which is present in inflammation ', 
it must not be permitted in excess, however, as undue amounts may 
produce nausea, flatulence and even vomiting and diarrhoea. Ice-water 
is best adapted to febrile conditions, sipped often and in small quantities. 
When drunk inordinately at meals, a custom prevalent in the United 
States, it acts not only injuriously upon digestion for the moment, but 
also superinduces a condition known as ice-water dyspepsia. To allay 
the thirst that follows a profuse perspiration brought on by exercise, 
the fauces should be rinsed before drinking and the fluid then slowly 
swallowed in small quantities. In constipation a tumblerful of water 
taken before breakfast will commonly bring about an evacuation of the 
bowels. The uses of water, as an external agent, have been noticed 
under the head of heat and cold, (pp. 33, 35.) 

Carbonic Acid Water (H 2 C0 3 ) (not official). — Water impregnated 
with a quantity of carbonic acid equal to five times the bulk of the 
water (which may be obtained from sodium bicarbonate or from 
marble, by means of diluted sulphuric acid) often proves useful in 
allaying nausea and vomiting, and is also a good vehicle for some of 
the neutral purgative salts which are of unpleasant taste. 

Carbonic acid gas may be taken in the form of natural mineral 
waters, as Apollinaris, Clysmic, Giesshiibler and Summit Soda Springs 
of California. These are particularly agreeable in cases of fever, and 
to relieve nausea and vomiting. Being alkaline they are adapted to 
prolonged use in the uric acid diathesis, particularly the Clysmic water. 
Mixed with milk they are well suited to acid dyspepsia. 

ACACIA— GUM ARABIC 

Description and Habitat. — Acacia, or Gum arabic, is a gummy 
exudation derived from Acacia Senegal and other species of Acacia 
{Nat. Ord. Leguminosae), thorny or prickly trees or shrubs of Africa 
and Arabia. Considerable gum * is collected by the Somali tribe on 
the N. E. coast of Africa, who obtain it by incision. 

Preparation, Varieties and Properties. — The gum exudes 
either through natural cracks in the bark or through incisions made 
to facilitate its exudation, and hardens on exposure. Several com- 
mercial varieties are known, as Turkey, Barbary, Senegal, India, etc., 

* Journ. of Pharmacy, XII, 226. J. Vaughan. 



DEMULCENTS— GUM ARABIC. 573 

of which the most important are Turkey gum and Senegal gum. 
I. Turkey gum (Kordofan gum) is the kind usually found in the shops. 
It consists chiefly of small, irregular fragments, interspersed with larger 
pieces of a whitish color, which is sometimes slightly tinged with 
yellow or reddish-yellow. It is purer than other varieties, and is 
generally characterized by innumerable minute fissures pervading its 
substance. 2. Senegal gum occurs in roundish or oval unbroken 
pieces, sometimes whitish, but generally yellowish, reddish or 
brownish-red. All the varieties are more or less transparent, hard, 
brittle and pulverizable, and form a white powder. They are inodor- 
ous, with a feeble, slightly sweetish taste, and when pure dissolve 
wholly in the mouth. When kept in a dry place they undergo no 
change by time. 

Chemical Constituents. — Acacia consists almost wholly of a 
peculiar proximate principle, usually termed Gum, but latterly 
designated as Arabin. It is soluble in hot or cold water forming a 
viscid solution called mucilage, and is insoluble in alcohol, ether and 
the oils. Its aqueous solution is acid. Arabin (gummic or arabic 
acid) (C 12 H 22 O n ) is combined with about 3 per cent, of lime, forming 
a soluble salt, calcium gummate. Gums of inferior transparency and 
solubility contain bassorin, an inert principle, insoluble in water and 
alcohol. 

Incompatibles. — Alcohol precipitates gum from its aqueous 
solution; lead acetate (which is also a delicate test), lead nitrate, 
solution of the ferric salts and borax in concentration render its 
solution turbid and jelly-like. 

Aids. — Mucilage of tragacanth, slippery elm, and sassafras pith. 

Effects and Uses. — Acacia is employed, internally, as a demul- 
cent in gastro-enteric inflammation, as enteritis, diarrhoea, dysentery, 
cases of acrid poisoning, etc.; as a lubricant to the fauces in catarrhal 
affections, as pharyngitis ; and also as a vehicle for anodynes and expec- 
torants in cough mixtures ; and as a diluent m fevers and inflammatory 
cases. 

Administration. — It is usually administered in solution (gj to 
boiling water Oj, to be given when cool) ; in cases of irritation of the 
fauces it may be taken into the mouth and allowed slowly to dissolve. 
For pharmaceutical purposes acacia is much used to suspend insoluble 
substances in water, and in making pills and lozenges. Mucilago 
acacice {mucilage of acacia) is used in making pills, emulsions, etc.; it 
becomes sour by keeping. Syrupus acacice (syrup of acacia) (25 per 



574 MATERIA MEDICA AND THERAPEUTICS. 

cent, of mucilage of acacia mixed with 75 per cent, of syrup) is used 
for the same purpose and must be freshly made. Emulswn amygdalce 
[emulsion of almond) is made by dissolving a mixture of 6 parts of 
blanched sweet almonds, 1 part of acacia, and 3 parts of sugar, in 100 
parts of distilled water ; it is a pleasant demulcent and vehicle for 
other medicines ; dose f5ij-iv. 

TRAGACANTHA-TRAGACANTH. 

Description and Habitat. — This is a gummy exudation derived 
from the Astragalus gummifer and other species of astragalus (Nat. 
Ord. Leguminosae), small shrubs found in Persia, Asia Minor and 
countries bordering on the Levant, with numerous branches covered 
with imbricated scales and beset with spines. 

Preparation, Properties and Constituents. — Tragacanth ex- 
udes spontaneously in the hot weather, and hardens, as it exudes, in 
forms of various shapes. It occurs in irregular tortuous flakes or fila- 
ments, of a whitish or yellowish-white, or occasionally a slightly red- 
dish color, somewhat translucent, resembling horn in appearance. It 
is hard and fragile, but very difficult of pulverization, and has no smell 
and very little taste. When heated with water it swells and forms a 
paste, and if agitated with an additional quantity it forms a uniform 
mixture, from which it is, however, almost entirely deposited upon 
standing a day or two. It contains two constituents, one soluble in 
water resembling arabin, but not identical with it, combined with cal- 
cium, the other termed tragacanthin (C 12 H 20 O 10 ). 

Effects and Uses. — Tragacanth is seldom given internally, on 
account of its difficult solubility. It is useful in suspending heavy in- 
soluble powders, and answers better than gum arabic to impart con- 
sistency to lozenges. 

Administration. — Mucilago tragacanthce [mucilage of tragacantli) 
— tragacanth 6 parts, with glycerin 18 parts, in water enough to make 
the whole weight 100 parts, is used in making pills and troches, and 
for the suspension of heavy insoluble metallic substances. 

LINUM— LINSEED. 

Description and Habitat. — This is the seed of Linum usitatis- 
simum, or Common Flax (Nat. Ord. Lineae), an annual plant of the 
height of two feet, originally a native of eastern countries, but natural- 
ized in Europe, and cultivated in all parts of the world. 

Properties. — The seed and oil are both official. The seeds are 
about a line in length, oval, smooth and glossy, of a brown color ex- 



DEMUL CENTS— LINSEED. 575 

ternally and yellowish within. Linseeds are inodorous, and have an 
oily, mucilaginous taste. 

Chemical Constituents. — They contain 30 or 35 per cent, of 
fixed oil, a large proportion of mucilaginous matter, vegetable albumen, 
etc.; the mucilaginous matter, which is found chiefly in the husks of 
the seeds, consists, about one-half, of a principle soluble in cold water, 
resembling arabin, and about one-third of a principle insoluble in 
water. The oil (oleum lini or linseed oil) is obtained by expression 
from the interior part of the seeds. 

Fig. 57. 




LINUM USITATISSIMUM. 



Effects and Uses. — Linseed oil is laxative in the dose of fSj-ij, 
but it is chiefly applied topically, mixed with an equal amount of lime- 
water, forming lime liniment (linimentum calcis) usually termed " car- 
ron oil," to burns and scalds. It is applied spread on lint and covered 
with oiled silk, making a soothing dressing. Decoction is an improper 
mode of preparing a demulcent solution of flaxseed, as boiling extracts 
part of the oil ; but it answers very well when it is used as a laxative 
enema. Linseed-tea is made with 51 to 2 of the seeds, bruised gly- 
cyrrhiza 5ij, macerated 2 hours in boiling water (Oj); or the juice of 
one lemon maybe added in place of the glycyrrhiza — a useful demulcent 
drink in cystitis and gonorrhoea. Ground linseed forms a much-used 
emollient poidtice {vide p. 570), which is prepared by gradually adding 



576 MATERIA MEDIC A AND THERAPEUTICS. 

boiling water to flaxseed meal in a vessel previously heated, and con- 
stantly stirring until it makes a smooth dough of proper consistence, 
which is then spread on muslin and a piece of gauze or mosquito- 
netting placed upon it, to prevent it from adhering to the skin. After 
the poultice is applied, it should be covered with oiled silk or waxed 
paper, to retain the heat and prevent evaporation. The cake remaining 
after the expression of the oil retains the mucilaginous and albuminous 
constituents of the seed, and forms a food for cattle under the name of 
oil-cake. This is used for making poultices, but it is inferior to the 
meal made from the seeds which have not been deprived of their oil. 

Three substances are considered here, though not of a demulcent 
nature, that are made from flax and hemp, viz. : Lint, Charpie, and 
Oakum. Lint is a soft, flocculent substance, produced by scraping 
one side of old linen with a flat knife ; patent lint is made by scraping 
new linen, generally specially manufactured, longitudinally after 
removal of the transverse threads. Charpie is old unravelled linen. 
Oakum is a coarse, fluffy, brown, fibrous substance, of a tarry odor, 
and some absorbent power, made by picking old hempen rope to 
pieces. Lint is employed for general surgical purposes : oakum as 
a padding for splints, fracture boxes, compresses, about suppurating 
wounds, and to support pendulous parts as the scrotum in orchitis. 

OLEUM GOSSYPII SEMINIS— COTTON-SEED OIL. 

This is a fixed oil expressed from the seed of Gossypium her- 
baceum {vide p. 275) and other species of Gossypium. It is finally 
obtained as a clear, pale-yellow, oily liquid, without odor, and having 
a bland, nut-like taste. It contains olein and palmitin. It is very 
bland, and may be used as a substitute for almond or olive oil. It is 
employed topically as an ingredient of limmentum ammonia {vide p. 
554), linimenlum calcis (p. 495), linimentum camphor ce (vide p. 130), 
and linimentum plumbi subacetatis, — the latter no longer official. 

Barley water, decoctum hordei, (not official) : a useful demulcent 
and nutritive drink is made with pearl barley §ij, boiling water f§xxx; 
boil for 20 minutes and strain. The barley should first be washed in 
cold water ; dose ad libitum ; serviceable to allay the ardor urince of 
gonorrhoea, and as a diluent in acute and chronic cystitis. 

ULMUS— SLIPPERY-ELM. 

Description and Habitat. — This is the inner bark of Ulmus 
fulva, or Slippery-Elm (Nat. Ord. Urticaceae), a lofty indigenous tree 



DEMUL CENTS— MARSHMALL 01V. 577 

which is found throughout the United States north of Carolina, and 
grows most abundantly west of the Allegheny Mountains. 

Description and Constituents. — The inner bark is prepared for 
use by the removal of the epidermis ; it is found in the shops in long 
flat pieces, of fibrous texture, tawny on the outer surface and reddish 
on the inner, of a peculiar but not unpleasant smell and a very mucil- 
aginous taste. It affords a light-grayish, fawn-colored powder. A 
large quantity of mucilaginous matter is contained in it, which is yielded 
readily to water, also some tannic acid. 

Effects and Uses. — Slippery-elm bark is a demulcent, employed 
in acute dysentery, diarrhoea, genito-urinary diseases, catarrhs, etc. It is 
also nutritious. Topically, it is an excellent emollient application, in the 
form either of infusion or of poultice made with the powder. It has 
been also made into a spongy mass, as a tent to dilute the os uteri, 
in dysmenorrhea. The infusion is an excellent soothing and cleansing 
mouth-wash in simple stomatitis rendered alkaline with sodium bicar- 
bonate. 

Administration. — The infusion — mucilago idmi (inucilage of slip- 
pery-elm bark) (2 parts to water 100 parts) — may be used ad libitum. 

sassafras medulla— sassafras pith. 

Sassafras pith is the pith of the stems of Sassafras officinale (vide 
p. 385). It occurs in light, spongy, whitish, slender, cylindrical pieces, 
of a mucilaginous taste. It abounds in a gummy matter, which it 
yields readily to water, forming a limpid, viscid mucilage. This mucil- 
age (mucilago sassafras medtdlce) (2 parts to water 100 parts) — is a 
pleasant demulcent drink in dyspeptic, nephritic, and catarrhal affections, 
and is much used as a soothing application in ophthalmia ; it is added 
to collyria, f 5i to f§i. 

ALTH^A-MARSHMALLOW. 

Description and Habitat. — The root of Althaea officinalis (Nat. 
Ord. Malvaceae), commonly known as Marshmallow, an herbaceous 
European plant, occasionally found, too, on the borders of salt marshes 
in our own country, with ovate, soft, velvety, crenate leaves and pretty 
flesh-colored flowers, is much used in Europe as a demulcent. 

Properties and Constituents. — The roots are imported in pieces, 
three or four inches in length, of nearly the thickness of the finger, 
light, easily broken, white externally, of a peculiar faint smell and a 
mild, mucilaginous sweetish taste. The chief constituents of marsh- 
mallow are mucilage and starch, the former soluble in cold water, the 
37 



578 MATERIA MEDICA AND THERAPEUTICS. 

latter requiring boiling water. It contains also asparagin (C 4 H 8 N 2 3 + 
HoO), a crystalline principle found in asparagus-shoots and other 
plants. 

Effects and Uses. — Marshmallow decoction is employed as a 
demulcent in inflammatory and irritated conditions of the mucous 
membranes of the respiratory, digestive and urinary organs, and poul- 
tices made of the bruised or powdered root are used externally. 

Administration. — The syrup is official [syrupus althece)\ used as 
a flavoring vehicle, dose ad libitum. 

OLEUM SESAMI-OIL OF BENNE. 

Description and Habitat. — This is a fixed oil expressed from 
the seed of Sesamum indicum (Nat. Ord. Pedaliaceae), an annual 
plant, growing to the height of four or five feet, with ovate-lanceolate, 
lobed leaves, reddish-white axillary flowers, and an oblong capsule 
containing small, oval, yellowish seeds. It is a native of India, but is 
now raised throughout Asia and in Egypt and Italy, also in South 
Carolina and in the neighborhood of Philadelphia. 

Chemical Constituents. — The seed contains a fixed oil, and the 
leaves yield to cold water a large quantity of mucilage resembling that 
of sassafras-pith. 

Effects and Uses. — This is a highly esteemed demulcent drink, 
used in clwlera infantum and infantile bowel complaints. The oil 
(oleum sesami), which is inodorous, of a bland, sweetish taste, and 
keeps well, may be used internally or topically as a substitute for 
olive-oil. 

GLYCYRRHIZA— LIQUORICE ROOT. 

Description and Habitat. — Glycyrrhiza is the root of Gly- 
cyrrhiza glabra (Nat. Ord. Leguminosae), a small herbaceous perennial 
plant, of the countries around the Mediterranean. It is imported 
from Sicily and Spain. 

Properties and Constituents. — As found in the shops gly- 
cyrrhiza is in long wrinkled pieces, often worm-eaten, varying from 
a few lines to more than an inch in thickness, externally grayish-brown, 
internally yellowish, without smell, and of a sweet, mucilaginous, some- 
times slightly acrid taste. The best pieces are of the brightest yellow 
internally. The powder is grayish-yellow, or, if it be powdered with 
the epidermis removed, pale sulphur-yellow. The constituents of gly- 
cyrrhiza are a peculiar, transparent, yellow, uncrystallizable sugar, 
termed glycyrrhizin, (C 16 H 24 6 ) (which is scarcely soluble in cold water, 



DEMULCENTS— LIQUORICE ROOT. 579 

but soluble in boiling water and alcohol, and is a glucoside, splitting 
up, when warmed with a dilute acid or upon being boiled, into gly- 
cyrrhetin and sugar), starchy asparagin, an acrid resin, etc. 

Effects and Uses. — Liquorice root has a sweetish, agreeable, 
taste, and when chewed increases the flow of saliva. A decoction of 
glycyrrhiza is a useful demulcent in dysenteric, catarrhal and nephritic 
affections ; it is also added to decoctions of acrid substances, to cover 
their taste and acridity. A bit of the extract, or a lozenge, dissolved 
in the mouth, will allay hoarseness and pharyngeal congh. It should be 
made of the root deprived of its cortical part, which is acrid and with- 
out demulcent virtues ; by long boiling the acrid resin is extracted. 
The powder is used in making pills. 

Fig. 58. 




GLYCYRRHIZA GLABRA, ROOT. 

Administration. — A fluid extract (extr actum glycyrrhizo? fluiduni) 
is official, and is a useful addendum to cough-mixtures and to disguise 
the taste of ammonium carbonate or chloride, or quinine. 

Glycyrrhizinum Ammoniatum (Ammoniated Glycyrrhizin) is pre- 
pared by macerating and then percolating glycyrrhiza with water of 
ammonia, precipitating with sulphuric acid, washing the precipitate 
and dissolving in water of ammonia and spreading on glass-plates to 
dry. It may be used for the same purpose as the other preparations of 
liquorice. 

Extractum Glycyrrhizae [Extract of Glycyrrhiza) — Extract of Li- 
quorice. 

Preparation and Description. — This is made by the evapora- 
tion of a decoction of the half-dried root. The crude extract, when 



5S0 MATERIA MEDICA AND THERAPEUTICS. 

good, occurs in black, flattened, cylindrical rolls, about an inch in 
diameter, which are dry, brittle, with a shining fracture, of a sweet 
taste, and are quite soluble in water. It is, however, much sophisti- 
cated, and for internal use is generally refined by dissolving the impure 
extract in water and water of ammonia, without ebullition, straining 
the solution and evaporating ; sugar is often mixed with it, and some- 
times mucilage or glue. Refilled liquorice {extractum glycyrrhizcz 
purum) is in small cylindrical pieces, not thicker than a pipe-stem. 

Effects and Uses. — The taste of liquorice-extract is sweet and 
peculiar, and it slowly dissolves in the mouth, lubricating and soothing 
the fauces. It is chiefly employed for pharmaceutical purposes. It 
is, however, a pleasant demulcent, much used as an addition to cough- 
mixtures and lozenges and to disguise the taste of acrid infusions, de- 
coctions, turpentine, hyoscyamus, quinine, etc. 

Administration. — Mistura glycyrrhizcz composita {compound mix- 
ture of liquorice), commonly called brown mixture, consists of the pure 
extract, 3 parts; mucilage of acacia, 10 parts; syrup, 5 parts; paregoric, 
12 parts; antimonial wine, 6 parts ; sweet spirit of nitre, 3 parts; water, 
enough to make 100 parts ; dose, f§ss ; an excellent preparation in the 
treatment of bronchitis without fever. For pidvis glycyrrhizcz compositus 
see Senna. Extractum glycyrrhizcz enters into the composition of 
several troches already noticed, and it is used as an excipient for pills. 

CETRARIA— ICELAND MOSS. 

Description and Habitat. — Cetraria islandica (Nat. Ord. Lichenes), 
is a foliaceous, erect lichen, from two to four inches high, found in the 
northern latitudes and mountainous districts of the new and old con- 
tinents. It is obtained principally from Norway and Iceland, but is 
said to be abundant also in New England. 

Properties and Constituents. — As found in the shops it consists 
of irregularly-lobed and channelled coriaceous leaves, fringed at their 
edges with rigid hairs, of a brownish or grayish-white color, darker on 
the upper surface, and sometimes marked with blood-red spots. It is 
almost odorless, and has a bitter, mucilaginous taste; its powder is 
whitish-gray. It gives up its virtues to boiling water, and consists 
chiefly of a kind of amylaceous matter (which is colored blue by 
iodine, and is termed licheni?i, C 12 H 20 O 10 ), and a bitter-principle termed 
cetrarin (C 18 H 16 8 ) ; it contains, besides, other principles. 

Effects and Uses. — Iceland moss is a demulcent tonic, and is 
also highly nutritious. It is adapted to cases requiring a light aliment 



DEMULCENTS— IRISH MOSS. 581 

combined with a mild and acceptable tonic ; and from its demulcent 
properties has a soothing influence in inflammations of the various 
mucous membranes. It is chiefly used in chronic affections of the pul- 
monary and digestive organs, as bronchitis and diarrhoea, in the form of 
decoction [decoctum cetrarice), which may be taken ad libitum. By 
maceration in water or a weak alkaline solution, Iceland moss may be 

Fig. 59. 




CETRARIA ISLANDICA. 

deprived of its bitter-principle ; and it is then used as a mild nutritive 
demulcent. 

CHONDRUS— IRISH MOSS. 

Description and Habitat. — Chondrus crispus, or Carragheen 
(Nat. Ord. Algae), is a marine alga found chiefly on the west coast of 
Ireland, and also on the coast of New England. It is also obtained 
from Chondrus mammilosus. 

Preparation, Properties and Constituents. — It is prepared 
for use by washing, bleaching, and drying. As found in the shops 
it consists of fronds from two to three or four inches long, mostly 
yellowish or dirty-white, but intermixed with purplish-red portions, 
nearly inodorous, and of a mucilaginous taste. It swells up in warm 
water, and is almost entirely dissolved when boiled. Its chief con- 
stituent is a peculiar mucilaginous principle, for which the term Carra- 
gheenin has been proposed ; and it contains also some mucus, resins, 
etc. 



582 MATERIA MEDICA AND THERAPEUTICS. 

Effects and Uses. — It is a very agreeable nutritive demulcent, 
useful in boivel complaints and pectoral affections. 

Administration. — It may be given in the form of decoction 
(oss to water Ojss boiled to Oj) flavored with lemon-juice and sugar; 

Fig. 60. 




CHONDRUS CRISPUS. 

or it may be made with milk or cream into blanc-mange, which forms 
an excellent light diet for the sick. 

AMYLUM-STARCH. 

Definition. — This term is applied by the Pharmacopoeia to the 
fecula of the seed of Zea Mays. {Nat. Ord. Gramineae). It is a 
proximate principle, however, which pervades the vegetable kingdom, 
being found in various parts of plants, especially in seeds, tubers and 
bulbous roots. 

Preparation and Properties. — It is obtained by bringing the 
substances in which it exists to a state of minute division, agitating or 
washing them with cold water, straining or pouring off the liquid, and 
allowing it to stand until the fecula which it holds in suspension has 
subsided. It occurs as a white, opaque, odorless, tasteless powder, 
or in columnar masses of a crystalline aspect, and produces a peculiar 
sound when compressed between the fingers. It is insoluble in alco- 
hol, ether, and cold water. 

Microscopical Appearance and Tests. — Examined under the 
microscope, starch is seen to consist of minute circular or lenticular 



DEMULCENTS— ANIMAL FATS. 583 

granules, the laminae of which are arranged around a central point or 
hilum, varying in size and shape in the different varieties of amylace- 
ous substances. The diameter of the wheat granule is about rata of 
an inch. The potato-starch granule is one of the largest, that of rice 
the smallest. The envelope of these granules is insoluble in cold water, 
but is ruptured by heat, so that the interior portion is exposed and 
becomes dissolved ; hence starch is said to be insoluble in cold, but 
soluble in boiling water. Starch is C 6 H 10 O 5 , and is classed with the 
carbohydrates. By the action of heat, or by long boiling with diluted 
sulphuric or hydrochloric acid, it is converted into dextrin, an isomeric 
soluble principle, and by the same process this may be converted into 
grape-sugar. The same change takes place in grains, after germina- 
tion, through the agency of a nitrogenous principle termed diastase. 
The test for starch is iodine, which forms with starch-solution a rich 
blue iodide ; nitric acid converts it into oxalic acid. 

Effects and Uses. — The starchy or farinaceous articles form an 
important group of nutrients. Their assimilation is affected by the 
albuminous principles of the digestive tube (salivin and pancreatin), 
which change starch into grape-sugar, the conversion taking place in 
the mouth and duodenum. Starch is used externally as a dusting 
powder to excoriated surfaces ; to prevent chafing (starch 10 parts, 
salicylic acid 3, and powdered soap-stone 8) ; to prickly heat with zinc 
oxide ; as the starch-poultice (by making a paste with dry starch and 
water, then adding boiling water, heating, stirring and spreading on 
cloth), and in solution as a vehicle for laudanum in the form of enema. 
It is the antidote for iodine. 

Glyceritum Amyli (Glycerite of Starch) {Plasma) contains 10 per 
cent, of starch thoroughly mixed with glycerin and dissolved by the 
aid of heat. It is excellent as a vehicle for astringent applications in 
ophthalmic surgery, and as an application to allay heat, burning and 
itching of the skin in scarlet fever, small-pox and excoriations ; in small- 
pox it is particularly pleasant to the patient, and has as much effect in 
preventing pitting as any other application. It is used as a substitute 
for ointments, and is a good excipient for pills. 

For external use, the animal fats are employed as emollients. 
When applied topically, they are absorbed and assimilated, and increase 
the body-weight; hence inunctions have been practised in wasting 
diseases, as phthisis, etc. They also reduce the temperature of the 



584 MATERIA MRDICA AND THERAPEUTICS. 

body in febrile conditions, and allay itching and irritation of the sur- 
face, and for this purpose they are employed in the exanthemata, as 
scarlet fever, measles, etc. They are also used as excipients for other 
medicines, in making ointments, etc. 

Adeps (Lard) is the prepared fat of Sus Scrofa (the hog) {Class, 
mammalia ; Ord., pachydermata) ; the internal fat of the abdomen is 
preferred, which is washed, melted and strained. Below the tempera- 
ture of 90 it occurs as a soft, white solid, which for medicinal use 
should be free from saline matter. It consists of olein and stearin. 

Effects and Uses. — It is used in pharmacy as an addition to 
poultices, and as an inunction in the exanthemata, particularly scarlet 
fever and measles. 

Administration. — Cerate [ceratum) is made by melting together 
70 parts of lard and 30 parts of white wax. Ointment [iinguentum) is 
made by melting together 80 parts of lard and 20 parts of yellow wax. 
Lard-oil [oleum adipis), expressed from lard, is a good vehicle for 
anodyne-enemata. 

Adeps Benzoinatus [benzoinated lard), formerly termed benzoi?iated 
ointment, consists of benzoin 2 parts in 100 parts of lard. 

Adeps Lanae Hydrosus [Hydrous Wool Fat). Formerly Lanolin. 

Description and Properties. — This substance, the description of 
which is based on the investigation of Liebreich * (by whom it was 
introduced), Lassar,f Aubert,J W. G. Smith, § and Kinner,|| is the 
purified fat of sheep's wool, containing about 30 per cent, of water; 
chemically, it is a fatty salt of cholesterin. It is not a secretion of the 
sebaceous glands, but a retrograde metamorphosis of keratin. It is 
neutral, of slight odor, yellowish-white color, of ointment consistency, 
not readily decomposed, blends easily with glycerin and fats, has con- 
siderable capacity for mixing with water (about twice its weight), and 
is not saponifiable. 

Local Effects. — Lanolin when applied to the skin acts as a 
bland lubricant. Liebreich (loc. cit.) states that corrosive sublimate 
mixed with lanolin and brought in contact with the skin, soon pro- 

* Berlin Klinsche Wochen., No. 47, p. 761. f Ibid., No. 5, p. 75. 

% " Congres de Chirurgie" Paris, 1 886, quoted. 
I Brit. Med. Jour., 1886, p. 1106. 
|| Journ. of Cutaneous and Venereal Diseases, 1 886, p. 270. 



DEMULCENTS— OLEIC ACID. 585 

duces a metallic taste in the mouth. Lassar (Joe. cit.) has shown, too, 
that cinnabar mixed with it penetrates more deeply into the skin than 
with other ointments. Aubert (loc. cit), on the other hand, affirms 
that he was unable to obtain the constitutional effects of atropine in 
lanolin rubbed on the skin ; in fact, he considers it retards, rather than 
accelerates, absorption. The weight of experience, however, now 
shows that it possesses considerable penetrative power. 

Medicinal Uses. — It is an excellent excipient with which to apply 
medicines to the skin ; to assist the removal of scales, as in psoriasis ; 
to lubricate the cracks and fissures of eczema after the acute stage has 
been passed, and, in fact, wherever the use of an unirritating, unde- 
composable ointment is indicated. It may be diluted with other fats 
and flavored with oil of lavender ; or one part of lanolin to 3-5 of vase- 
line or lard. 

Sevum (Mutton-Suet) is the internal fat of the abdomen of Ovis 
Aries (the sheep) (Class, Mammalia; Ord., Ruminantia), purified by 
melting and straining. It is composed almost exclusively of stearin, 
but also contains some palmitin, olein and hircin. 

Cetaceum (Spermaceti) is a peculiar concrete fatty substance ob- 
tained from Physeter macrocephalus or spermaceti whale (Class, Mam- 
malia; Ord., Cetacea). It consists almost entirely of cetyl palmitate 
(C 16 H 3 3C 16 H 31 2 ) or cetin, but recently has been shown to contain also 
ethers of stearic, myristic and laurostearic acids ; and of the alcohols, 
lethal (C 12 H 26 0), niethal (C 14 H 30 O), ethal (C 16 H 34 ) and stethal (C 18 H 33 0). 
Spermaceti cerate (ceratum cetacei) is made by melting together 10 parts 
of spermaceti and 35 parts of white wax, and then adding 55 parts of 
olive-oil, previously heated. Ointment of rose-water (see p. 189) con- 
tains spermaceti. 

Cera Fiava ( Yellow Wax) is a peculiar concrete substance pre- 
pared by Apis mellifica, the honey-bee ( Class, Insecta ; Ord., Hymen- 
optera). 

Cera Alba (White Wax) is yellow wax bleached. They are used 
chiefly in making cerates, ointments and plasters. 

acidum oleicum- oleic acid. 

Source. — Oleic acid (HQgH^C^) exists in fats and fixed oils com- 
bined with glycerin. 

Preparation and Properties. — It is obtained in an impure state 



586 MATERIA MEDICA AND THERAPEUTICS. 

as a secondary product at stearin-candle manufactories. The U. S. P. 
describes it as " An organic acid, prepared in sufficiently pure condi- 
tion by cooling commercial oleic acid to about 41 ° F., then separating 
and preserving the liquid portion." Oleic acid is a yellowish, oily 
liquid, which becomes brownish and rancid by exposure to the air, with- 
out smell or taste, soluble in alcohol and ether, but insoluble in water. 

Effects and Uses. — Oleic acid penetrates or soaks through the 
skin more readily than do the oils or fats. It is consequently employed 
as a vehicle in cutaneous medication, particularly in the form of the 
oleates. The oleates of the alkaline metals are soft soluble soaps ; those 
of the earthy metals are insoluble in water, but soluble in alcohol and 
ether. 

Oleic acid is used principally in preparing the oleates of veratrine 
(vide p. 246), of mercury {vide p. 444), and zinc (vide p. 200). Oleates 
of copper (p. 198) and bismuth (p. 206) are also employed. 

ACIDUM STEARICUM-STEARIC ACID. 

Source. — Stearic acid (HC 18 H 35 2 ), or stearin, forms one of the 
component parts of lard, and fixed oils united with glycerin. 

Preparation and Properties. — This, a recent addition to the U. 
S. P., is usually obtained, more or less impure, from the solid fats, as 
tallow. It is a white, glossy solid, without odor or taste, and perma- 
nent on exposure to air. It dissolves readily in ether, in about 45 parts 
of alcohol, and is insoluble in water. 

Effects and Uses. — Analogous to those of oleic acid ; it is em- 
ployed in pharmacy. See Suppositoria Glycerini,p. 589. 

OLEUM THEOBROMATIS-OIL OF THEOBROMA. 

Description and Habitat. — This oil, commonly known as But- 
ter of Cacao, is the fixed oil expressed from the seed of Theobroma 
Cacao (Nat. Ord. Sterculiaceae), a handsome tree, from twelve to twenty 
feet in height, growing in Mexico, the West Indies, Central America 
and South America. The fruit is an ovate-oblong capsule or berry, 
half a foot in length, with a thick, coriaceous, ligneous rind, inclosing 
a whitish pulp, in which numerous ovate seeds are embedded, about 
the size of an almond. Separated from the matter in which they are 
enveloped, these constitute the chocolate-nuts of commerce (see p. 134). 

Chemical Constituents. — They contain fixed oil (cacao butter), 
theobromine (C 7 H 8 N 4 2 ), and other matters. Theobromine is an alkaloid, 
analogous to caffeine in its effects. 



DEMUL CENTS— GL YCERIN. 587 

Preparation and Properties. — Cacao-butter is obtained by ex- 
pression, decoction or the action of a solvent. It occurs in whitish or 
yellowish oblong cakes, of the consistence of tallow, and of an agreea- 
ble odor and taste. It contains a large proportion of stearin, also pal- 
mitin and olein. 

Effects and Uses. — It is employed in pharmacy for coating pills, 
and also largely in preparing suppositories (p. 62), for which it is well 
adapted by reason of its consistence and blandness, and because it melts 
at the temperature of the body. It does not become rancid on expo- 
sure to the air. It may be used with advantage as an unguent in fever, 
to reduce the heat and allay the cutaneous irritation, and as a lubricant 
to chaps. 

GLYCERINUM-GLYCERIN. 

Source. — This is a substance which exists in oils in combination 
with the fatty acids (stearic, margaric, oleic, etc.), and is liberated from 
them when they unite with bases in the process of saponification, (p. 5 1). 

Preparation. — It was first obtained in the process for making 
lead-plaster, by mixing litharge (lead monoxide) with olive-oil and 
boiling- water, by which the fatty acid unites with the lead and is pre- 
cipitated, and the glycerin remains in solution. It is freed from any 
lead it may contain by means of a stream of sulphuretted hydrogen 
gas, and it is afterwards filtered through animal charcoal ; or, as it is 
now usually made more directly, by decomposing fats and distilling 
by steam under high pressure. Glycerin (C 3 H 5 3HO), or Glyceric 
Alcohol, is the hydrate of Glyceril, Glycil y or Propenyl, and is a tri- 
atomic alcohol. 

Properties. — It is a thick, syrupy liquid, colorless or straw- 
colored, unctuous to the touch, inodorous, of a sharp, sweet taste, and 
of neutral reaction. When pure its sp. gr. is 1.260, when it contains 
95 per cent, of absolute glycerin ; the Pharmacopoeia directs its sp. gr. 
to be 1.250. It is soluble in alcohol and water, but is insoluble in 
ether and chloroform, and does not evaporate when exposed to the air, 
but absorbs one-half its weight of water. It has remarkable solvent 
properties, dissolving iodine, bromine, the alkalies, tannic and other 
vegetable acids, pepsin, a large number of neutral salts, and many 
organic principles. Official solutions of medicinal substances in 
glycerin are termed glycerites (glycerita) ; (p. 61). 

Incompatibles. — It readily reduces potassium permanganate, 
with which it is incompatible. Mixed with chromic acid explosion 
may ensue. 



588 MATERIA MEDIC A AND THERAPEUTICS, 

Effects and Uses. — Glycerin is a bland and unirritating sub- 
stance. It has the capacity of diffusing itself freely over and through 
organic matter, incorporating itself between organic molecules, by 
which it is absorbed and appropriated. It has been used internally as 
a demulcent, but the weight of opinion is against its efficacy as a 
nutrient. It is as a topical application that it is chiefly employed. As 
an enema in dysentery ; to soften hardened mucus in the upper air 
passages, as in chronic nasal catarrh ; in various cutaneous affections, 
as cliaps ; in deafness attended with dryness of the meatus ; and as a 
vehicle or solvent for active medicines, glycerin is a valuable article. 
In gynaecological practice the introduction of a pledget of cotton 
soaked in glycerin within the vagina as far as the cervix is followed 
by a watery discharge which relieves neighboring congestion, and 
hence is an agent of some value in mild metritis ; or equal parts of 
carbolic acid and glycerin may be applied to the uterine cavity. 
Guzzo * recommends the following treatment to prevent extensive 
cicatrization following burns, and scalds: apply to the entire burned 
surface a piece of lint thickly spread with cold cream and covered 
with a compress two inches thick saturated with glycerin (freshly wet 
from three to six times a day; the whole dressing to be changed 
daily), and covered with a dry compress and bandage. This treatment 
failed in only one of fifty-one cases.f The application of glycerin to 
the crusts of small-pox will keep them moist and prevent desiccation. 

Attention has been called to small rectal injections of glycerin 
(f5/4-j) as a safe, sure and speedy means of opening the bowels in 
obstinate constipation. It seems to act by irritating the sentient rectal 
nerves, leading to powerful reflex peristalsis, which ends in defecation 
(Althaus,J Anacher, § and Mayer ||). The liquid may be introduced 
by a urethral rubber-syringe. 

Administration. — Glycerin is not taken internally alone. It is 
prescribed as a lubricant and diluent with such expectorant syrups, as 
those of squill, senega, and tolu, in the proportion of 3 to I of glycerin. 
It renders more palatable the taste of disagreeable medicines, as 
tincture chloride of iron. A glycerin soap, 20 per cent., may be had 
in the shops. 

* GaillarcTs Med. Jour., March, 1882. 

■f Arch. Dermat., Oct. 1882. 

%Brit. Med. Journ., Dec. 24, 1887, p. 1879. 

\Deuts. Med. Wochen., Sept. 15, 1887, p. 823. 

j| Med. News, Feb. 25, 1888, p. 201. 



DEMUL CENTS—SOFT PE TR OLA TUM. 589 

Glyceritum amyli (glycerite of starch) has already been considered 
(see p. 583). For glycerite of carbolic acid, see Carbolic Acid. The 
U. S. P. of 1890 has introduced suppositoria glycerini, each containing 
about 5 1^2 of glycerin, sodic carbonate gr. 4^, and stearic acid 

gr- 7V2- 

Glyceritum vitelli (glycerite of yolk of egg) (vitellus, yolk of egg) is 

made by mixing thoroughly 45 parts of fresh yolk of egg with 55 
parts of glycerin. It is a vehicle for the administration of cod-liver 
oil, a few drops of some aromatic being added as a flavoring in- 
gredient. 

PETROLATUM MOLLE— SOFT PETROLATUM. 

Source. — Petrolatum is a mixture of hydrocarbons of the marsh- 
gas series, obtained by distilling the lighter and more volatile portion 
from American petroleum, and purifying the remainder. Mineral oils 
have been known from time immemorial, and were obtained by the 
ancients from Sicily, the Ionian Islands and Persia ; later, they were 
found in various parts of Europe, Asia and North America, but did 
not become an important article of commerce until 1859, wnen the 
first oil-well was sunk near Titusville, in Pennsylvania. 

Properties and Chemistry. — Petrolatum is a yellowish, odor- 
less, transparent, semi-solid, fatty substance, melting at from 104 to 
124 F., insoluble in water and cold alcohol, more so in boiling ab- 
solute alcohol ; readily soluble in ether, chloroform, oil of turpentine, 
benzine, and the fixed and volatile oils. It consists principally of the 
hydrocarbons of the marsh-gas series. It has been introduced into 
the Pharmacopoeia as a substitute for vaseline, cosmoline, and other 
copyrighted preparations, which consist of mixtures of paraffine and 
the heavier petroleum oils, and, like them, possesses the advantage 
over the animal oils and fats of not becoming rancid. 

Petrolatum Liquidum (Liquid petrolatum). — " A mixture of hydro- 
carbons, chiefly of the marsh-gas series, obtained by distilling off the 
lighter and more volatile portions from petroleum, and purifying the 
residue when it has the desired consistence." U. S. P., 1890. It is a 
colorless or yellowish liquid, tasteless and odorless, readily soluble in 
alcohol, ether, chloroform, oil of turpentine, the fixed (except castor oil) 
and volatile oils. 

Petrolatum Spissum (Hard petrolatum). — " A mixture of hydro- 
carbons, chiefly of the marsh-gas series, obtained by distilling off the 
lighter and more volatile portions from petroleum and purifying the 
residue when it has the desired melting point." U. S. P., 1890. It is a 



590 MATERIA MEDIC A AND THERAPEUTICS. 

fat-like mass of the consistence of a cerate, white or yellowish-white, 
and without taste or odor. 

Effects and Uses. — Locally, it is a bland, protectant unguent. 
Luff claims that remedies incorporated with it are absorbed by the 
skin. When taken internally, in large doses, petrolatum is said to cause 
giddiness and oppression, with palpitation and headache. It seems to 
be well borne by the stomach, and causes no diarrhoea. It is employed 
only topically as an inunction in scarlet fever, measles, roseola, the ripen- 
ing papules of small-pox, and cutaneous affections such as lichen and 
chaps, to blistered surfaces, and it forms an admirable basis or excipient 
for ointments and drugs. It is an excellent dressing for abrasions 
mixed with carbolic acid gr. v-x to oj. 

Administration. — Petrolatum Molle is to be dispensed when petro- 
latum is prescribed without further specification. 

SACCHARUM— SUGAR. 

Source and Varieties. — Sugar (C 12 H 22 O n ) is a principle diffused 
through the vegetable world under many forms, all distinguished by a 
sweet taste. They are divided into two chief groups — Cane-Sugar and 
Grape-Sugar. Cane-sugar is the product of Saccharum officinarum 
(Nat. Ord. Gramineae), a native of tropical countries, cultivated most 
successfully in the West Indies, the Sandwich Islands, and to some 
extent in Louisiana. It has a general resemblance to Indian corn. 

Preparation and Properties. — The juice of the sugar-cane is 
extracted by crushing and expressing the stalks; it is then boiled with 
quick-lime, strained, and reduced by evaporation to a thick syrup, 
which is cooled and granulated in shallow vessels. Razv sugar is 
refijzed by the agency of animal charcoal. Cane-sugar is also made in 
France and Belgium from the beet-root, Beta Vulgaris. When pure, 
cane-sugar is white, crystallized in translucent, double oblique prisms, 
very sweet, soluble in one- third its weight of water, in alcohol, but not 
in ether. At a heat of 220 F. it melts and cools into a glassy, amor- 
phous mass, known as barley-sugar ; from a strong solution it can be 
made to crystallize slowly upon a string as rock-ca?idy. 

The uncrystallizable portion, which is drawn off in the granu- 
lation of sugar is molasses or treacle, a dark brownish-black, syrupy 
liquid. 

Grape-sugar is the sugar of grapes and other acid fruits ; it is also 
found in the liver and blood of mammalia, and in the urine of diabetes 
mellitus. It may be procured artificially by acting on starch with 



DEMUL CENTS— S A CCHARIN. 591 

diluted sulphuric acid. It occurs as whitish or grayish-white, non- 
crystalline masses, or as a dense transparent syrup. 

Chemistry. — Cane-sugar (C 12 H 22 O n ) combines with alkalies to 
form saccharates. Nitric acid with heat converts it into oxalic acid. 
Grape-sugar (C 6 H 12 6 .H 2 0), when boiled with an alkali, is transformed 
into the acid of molasses, melassic acid; mixed with solution of 
potassium hydrate and a weak solution of cupric sulphate, it attracts 
oxygen, and causes the precipitation of a reddish, cuprous oxide 
(Cu 2 0). By fermentation cane- and grape-sugar yield alcohol and C0 2 . 

Effects and Uses. — Sugar, especially in the form of barley- 
sugar, is an excellent demulcent to relieve hoarseness; much of the 
cough-relieving action of cough-syrups is due to the sugar they con- 
tain. It abates thirst, and is used to flavor refrigerant drinks. For 
pharmaceutical purposes sugar is much employed, for its agreeable 
taste, and also as a preservative of vegetable substances, and to protect 
mineral medicines from oxidation. Molasses, sympus fuscus, and the- 
riaca, treacle, (not official) are slightly laxative as well as demulcent. 

Mel [Honey). — This saccharine liquid, the familiar product of the 
bee {Apis Mellifica), best used in the form of mel despumatum [clarified 
honey), is a slightly laxative article of food, and is used in pharmacy, 
and as an agreeable demulcent ingredient in gargles. 

Saccharum Lactis [Sugar of Milk) (C 12 H 22 O n .H 2 0), the saccharine 
principle of milk obtained from whey, is used as a bland non-nitrogen- 
ous article of diet. It is used to insure the admixture of powders, as 
in pidvis ipecacuanha et opii, and extemporaneously in prescribing 
powders. 

SACCHARIN* (Not Official). 

Description and Properties. — This, a recently introduced ther- 
apeutic agent, is a product of the coal-tar derivatives, being derived 
from the aromatic group of hydrocarbons, and is chemically anhydro- 
orthosulphamin-benzoic acid (Fahlbergf). It is a white, uncertainly 
crystalline powder, unalterable at ordinary temperatures, slightly solu- 
ble in cold water, imparting to that liquid a feebly acid reaction, dis- 
solves in alcohol, glycerin and ether, and unites with the alkalies to 
form definite salts. Its most characteristic property is sweetness, sac- 

* Brit. Med.Journ., Oct. 16th, 1887. 

f Amer. Chem. Journ., 1879; Vol. 1, p. 436. 



592 MATERIA MEDICA AND THERAPEUTICS. 

charin being in this respect about 300 times greater than that of cane- 
sugar. Commercial saccharin contains about 50 per cent, of impu- 
rities. 

Physiological Effects. — When taken internally, even in large 
quantity (5ss-gr. lxxx), it is innocuous. Dogs fed on it together with 
their ordinary diet, according to Egasse,* did not increase in weight, 
nor was any alteration either in the quantity, specific gravity, or pro- 
portion of urea in their urine, found. It passes through the economy 
undecomposed, since it can be detected in the urine unchanged, but it 
has not been discovered in the saliva or faeces. In its exit by the 
kidneys it exerts a decided influence in restraining the alkaline fer- 
mentation of the urine, hence it has proved valuable to correct the 
fetor of the urine in chronic cystitis. 

Medicinal Uses. — It is chiefly employed as a substitute for sugar 
in obesity, in diabetes mellitus and gout, gr. j-ij being sufficient to 
sweeten the tea, coffee, sugar or food ; and as a corrective of the taste 
of certain bitter medicines, as quinine. 

ORDER IV.— PROTECTANTS AND ABSORBENTS. 

Protectants of the class here considered are agents, employed 
externally, which shield any surface from extraneous action. They 
are : calcii sulphas exsiccatus, liquor sodii silicatis, liquor gutta-perchce, 
elastica, resina and its preparations, rubber adhesive plaster, ichthyocolla, 
pyroxylinum, collodium, collodium flexile, collodium stypticum, lycopodium 
and talc. Calomel, bismuth, magnesia, and the fixed oils also posses s 
protective virtues, but these have been considered in their respective 
chapters. 

Absorbents (from ab and sorbere to suck up) are agents which im- 
bibe or take up any fluid in their immediate vicinity by capillary attrac- 
tion ; they act internally as well as externally. Some possess haemos- 
tatic properties when applied to bleeding vessels by retaining the blood 
until an adhesive clot is formed. Under this class are considered 
charcoal, cotton, sponge and bran. 

PROTECTANTS. 

Calcii Sulphas Exsiccatus [Dried Calcium Sulphate, or Gypsum) 
(CaS0 4 +H 2 0) is only employed to make immovable dressings 
(plaster of Paris bandage) for fractures, sprains, dislocations, etc., on 

* Bull. Gen. de Therap., Oct. 30th, 1888, p. 337 ; an elaborate article. 



PROTECTANTS— ELASTICA, OR INDIA-RUBBER. 593 

account of its property of hardening when mixed with half its weight 
of water. If exposed to moist air it attracts water, becomes granular, 
and loses this peculiar property. When about to be applied a mixture 
of gypsum and water is made of the consistence of mush in a basin 
with which the bandage unrolled is impregnated ; after re-rolling it is 
quickly applied, with as many more similarly treated as may be 
necessary. The parts, if hirsute, should be shaved, and to prevent 
pressure a flannel bandage should be first wound round the limb. A 
mixture of the plaster must be rubbed over each roller after application. 

LIQUOR SODII SILICATIS— SOLUTION OF SODIUM SILICATE. 

Preparation and Properties. — This solution (commonly known 
as Solution of Soluble Glass) is made by fusing together fine sand and 
dried sodium carbonate, and dissolving the product in hot water. It 
is a semi-transparent, colorless, viscid liquid, without smell but having 
a sharp, alkaline taste, which, on drying, becomes a transparent glass- 
like mass. 

Effects and Uses. — It is employed only in making perma- 
nent dressings (the silica bandage) in the treatment of fracture, 
sprains, etc. For this purpose a roller bandage is applied to the limb 
or part and thoroughly coated with the solution by means of an 
ordinary painter's brush, and as many bandages as necessary are 
applied in turn, each well smeared with the solution. It hardens 
quickly, forming a light, stiff dressing. 

liquor gutta-percha— solution of gutta-percha. 

Preparation and Properties. — This is a solution of 9 per cent, 
of gutta-percha in 91 per cent, of commercial chloroform. (Dismissed 
from U. S. P. of 1890.) In preparing it lead carbonate is employed to 
free it from coloring matter. It is a clear, colorless or nearly colorless 
solution, and should be kept in well-stoppered glass-vials. 

Effects and Uses. — By the evaporation of the chloroform, this 
proves an admirable application to inflamed or abraded parts, in skin- 
affections, etc. ; it is also an excellent protective coating to parts threat- 
ened with bed-sores or liable to excoriations, and for the retention of 
medicinal substances upon the skin in dermal therapeutics, as chrysa- 
robin (q. v.) to ringworm. 

ELASTICA-INDIA-RUBBER, or caoutchouc. 

Description. — This, a substance introduced into the U. S. P. of 

1890, is "the prepared milk-juice of various species of Hevea, known 

in commerce as Para Rubber " {Nat. Ord. Euphorbiaceae). 
38 



594 MATERIA MEDICA AND THERAPEUTICS. 

Properties. — It occurs in cakes or balls, of brownish-black color, 
a doughy, elastic consistence, insoluble in water, but mixing with chlo- 
roform and oil of turpentine. 

Uses. — No medical. It is employed solely in the manufacture of 
surgical instruments. 

RESINA-RESIN (Colophony). 

Resina [Resin), commonly called rosin, is the residue after the 
distillation of the oil from turpentine. 

Properties. — It is a yellowish-brown, semi-transparent, solid, 
brittle substance, with a slight terebinthinate odor and taste — insoluble 
in water, soluble in ether, alcohol and the essential oils, readily uniting 
by fusion with wax and the fixed oils, and forming soluble soaps 
with the alkalies. When agitated with water, in a state of fusion, it 
becomes opaque and white. 

Effects and Uses. — It is not used internally, but is extensively 
employed in the formation of plasters and ointments, to which it com- 
municates great adhesiveness and slightly stimulant properties. 

Administration. — Ceratum resince {resin-cerate), basilicon ointment, 
is made by melting resin (35 parts), lard (50 parts), and yellow wax 
(15 parts) together ; it is an excellent mild stimulant application to 
burns, blistered surfaces, excoriations, etc. Compound resin-cerate may 
be made by melting Sxij of resin, suet and yellow wax, each, with gvj 
of turpentine and f 5vij of linseed oil — a good stimulant cerate, very 
popular under the name of Deshler's Salve — a favorite application to 
fissure of the nipples. Emplastrum resince {resin plaster), made by melt- 
ing 14 parts of resin with 80 parts of lead-plaster, and 6 parts of yellow 
wax, is the well-known yellow adhesive plaster which is used to retain 
the edges of wounds in contact, to produce extension in the treatment 
of fractures, to protect abraded surfaces, and to promote absorption as 
in hydrocele and orchitis. It must be heated before application, pref- 
erably on the side of a bottle containing hot water. 

A rubber adhesive plaster is now made that offers the advantage 
of sticking where applied without the aid of heat or other agent. It 
may be had from ]/ 2 inch to 14 inches wide, and up to 10 yards long. 

ICHTHYOCOLLA— ISINGLASS. 

This is prepared from the swimming bladder of Acipenser Huso 
(the sturgeon) and of other species of Acipenser {Class, Pisces; Ord., 
Sturiones), and is the purest form of gelatin. Court-plaster (Emplastrum 
ichthyocollce) is made by coating taffeta with a solution of isinglass. 



PR O TECTANTS— COLL OBION. 595 

It is protective, and is applied to excoriations. Gelatin is also used as 
an article of diet, and is employed in pharmacy to make capsules for 
the administration of disagreeable medicines, as a coating for pills, and 
as a basis for soluble bougies. 

PYROXYLINUM-PYROXYLIN. 

Preparation. — Pyroxylin, or Soluble Gun Cotton, is made by add- 
ing cotton (cellulin) to a mixture of nitric acid gradually added to sul- 
phuric acid, and allowing it to macerate ; it is to be washed first with 
cold water, and then with boiling water, and after being drained on 
filtering paper it is dried by means of a water-bath. 

Chemistry. — Cellulin is (C 6 H 10 O 5 ) which when treated with 
HN0 3 and H 2 S0 4 is converted into dinitro-cellulose by the substi- 
tution of 2 molecules of nitril (N0 2 ) for 2 atoms of its (H), forming 
pyroxylin. Pyroxylin has the appearance of ordinary cotton, but is harsh 
to the touch. It is insoluble in water and alcohol, but when freshly 
prepared, it dissolves in ether and alcohol, forming collodion ; it is 
liable to decomposition if kept for some time. 

COLLODIUM— COLLODION. 

Preparation and Properties. — This is a solution of pyroxylin (3 
parts) in stronger ether (75 parts) and stronger alcohol (25 parts). 
Collodion is a slightly opalescent, syrupy liquid, with a strong ethereal 
smell. By long standing it deposits a layer of fibrous matter, and be- 
comes more transparent ; this layer should be reincorporated by agi- 
tation before the eollodion is used. 

Physiological Effects. — When applied to the skin the solvent 
evaporates, and it forms a colorless, transparent, flexible and strongly 
contractile film. This film proves antiphlogistic by driving the blood 
away from a part, limiting effusion and promoting absorption, and at 
the same time acts as an admirable dressing by protecting an inflamed 
surface from the action of the air. 

Medicinal Uses. — It is a useful application to ulcers, fissures, and 
skin-diseases and abraded surfaces, and to seal up the eye-lids of the 
sound eye in ophthalmia with lint. It is employed also in surgery as a 
substitute for adhesive plaster, and in pharmacy as a vehicle for other 
medicines. Iodized collodion (a very good solution of iodine for exter- 
nal application) contains from ten to twenty grains of iodine in a fluid- 
ounce of collodion. It has recently been applied to the scalp once 
every 4 or 5 days with success afunctional alopecia* Collodion, fo^, 

* Brit. Journ. of Dermatology, July, 1892. 



596 MATERIA MEDICA AND THERAPEUTICS. 

and morphia sulphate, gr. ij-v, is a useful application to herpes 
zoster. 

Preservation. — It should be kept in cork-stoppered vials distant 
from fire. 

Collodium Flexile {Flexible Collodion). — This is made by mixing 92 
parts by weight of collodion, 5 parts of Canada turpentine and 3 parts 
of castor oil. This is a softer, more pliable and more elastic prepa- 
ration, useful in cases where the strongly contractile power of ordinary 
collodion is objectionable. 

Medicinal Uses. — It is a good application in eczema and excori- 
ations. Collodion, in all forms, is to be kept in well-stoppered bottles. 

Collodium Stypticum {Styptic Collodion) contains 20 parts by 
weight of tannic acid, 5 of alcohol, 25 of stronger ether and 50 of col- 
lodion. It is an excellent styptic application to leech bites and abrasions. 

LYCOPODIUM. 

Description and Habitat. — This is the spores of Lycopodium 
clavatum or Club-moss, and other species of Lycopodium (Nat. Ord. 
Lycopodiaceae), low, creeping perennials, found in the dry woods of 
Europe and America. The stem is from 2 to 4 feet long, with 
numerous short ascending branches, having linear awl-shaped leaves ; 
the sporules are found in reniform sporangia of the long peduncle 
which terminates the fertile branches. 

Properties and Constituents. — It consists of a fine, yellow, in- 
flammable powder ; odorless, tasteless, and not wetted by water, and 
contains fixed oil and volatile bases. 

Effects and Uses. — It is employed as a dusting powder, and, 
as it is not wetted by water, makes an excellent application for excori- 
ated surfaces, intertrigo, etc. It is particularly useful to prevent the 
irritatio7i or chafing caused by the urine or alvine dejections coming 
in contact with the tender or inflamed perineum and nates, in infantile 
cases. It is also used in pharmacy to prevent the adhesion of pills. 

A dusting powder in common use is Talc, magnesium silicate, or 
French Chalk, employed as an exsiccant and face-powder. 

ABSORBENTS. 

carbo ligni— charcoal. 

carbo animalis— animal charcoal. 

Although being deodorant and disinfectant as well as absorbent, 
the medicinal uses of charcoal may, perhaps, be appropriately noticed 
under this head. 



ABSORBENTS— ANIMAL CHARCOAL. 597 

Preparation and Properties. — Wood Charcoal is prepared by 
the exposure of wood to a red heat without access of air. For medi- 
cinal purposes the charcoal prepared from young willow shoots for the 
manufacture of gunpowder is preferred. It is a black, shining, brittle, 
porous substance, without odor or taste, composed of from 60 to 80 
per cent, of carbon, and insoluble in water. Animal Charcoal (carbo 
animalis) is prepared from bone. It comes in dull, black grains or pow- 
der, odorless and nearly tasteless, and insoluble in water and alcohol. 

Effects and Uses. — Locally, charcoal attracts and absorbs gases 
and vapors. It is not absorbed from the intestinal tract, being dis- 
charged with the faeces without action upon the economy. It is 
employed internally as an absorbent of acrid secretions and gases, in 
dyspepsia (in which it is often very useful), eructations, in gastric irri- 
tation, diarrhoea and dysentery. It may relieve the meteorism of 
typhoid fever. 

Administration. — Dose, from one to four teaspoonsful made into 
tablets. Purified animal charcoal [carbo animalis purificatus) is official* 
dose the same. Topically, it is used with effect to absorb the offensive 
gases given off from foul sores, in the form of poultice (vide poultices), 
mixed with flaxseed meal, or with bread-crumb, which is better from 
its porosity ; dry charcoal is sprinkled with advantage over sloughing 
ulcers, and it appears to promote the separation of the sloughs. 

Gossypium Purificatum [Purified Cotton). 

Effects and Uses. — This well-known filamentous substance 
separated from the seed of the varities of gossypium, is a useful 
application to burns and parts affected with erysipelas and rheumatism, 
either suitably medicated or alone, and is much used as a dressing in 
various surgical affections, and as a padding for splints. Deprived of 
oily matters by boiling with an alkali, it is known as absorbeitt cotton^ 
and when thus prepared should take up about fifteen times its weight 
of water. By exposure to high dry heat it may be rendered free of 
disease-germs, and then it forms the antiseptic cotton of modern 
surgery. Pledgets of cotton thus prepared are employed attached to 
a holder to apply remedies on. In aural therapy cotton is inserted 
as an artificial drum-membrane, and it is introduced within the canal 
for the purpose of drying it after syringing in the treatment of otorrhcea ; 
it is also retained within the meatus for the purpose of soaking up 
pus. When it is desired to apply dry heat or hot stupes to the eye, 
in iritis, hordeolum, ophthalmia, or keratitis, cotton is the most suitable 
material that can be employed. Impregnated with iodoform, cotton 






598 MATERIA MEDIC A AND THERAPEUTICS. 

may be packed in the vagina as a tampon, in various uterine 
hemorrhages (as in threatened abortion, etc.), or to give support and 
correct displacement in cases of version of the uterus. It is particularly- 
adapted to those cases in which, from inflammation or tenderness of 
the parts, an ordinary pessary could not be worn. To stop epistaxis 
pedgets of cotton are forced into the nose, and may be impregnated 
with astringents. It is also impregnated with carbolic, salicylic and boric 
acid, or corrosive sublimate, for use as a surgical dressing. 

SPONGIA— SPONGE. (Not Official.) 

Description and Preparation.— This is an organized, supple, 
elastic, porous, marine substance, belonging to the Protozoa, class 
Porifera, obtained from various seas, particularly about the coast of 
Florida and the Mediterranean. Before use sponge requires special 
preparation. To bleach it and remove sand, it must be beaten and 
soaked in a 10 per cent, solution of HC1 for twenty-four hours, and then 
thoroughly washed to remove traces of acid. An additional process is 
needed to complete the bleaching and render it antiseptic. 

Effects and Uses. — Sponge is employed in surgery for its ab- 
sorbent power and softness; viz., to wash and cleanse a part ; to take 
up pus and discharges in the form of compress or tampon, and to stay 
haemorrhage. Small bits of sponge are introduced within the nose to 
avert epistaxis. A sponge-tent consists of a conical piece of sponge 
wrapped with thread and immersed in hot wax. When applied within 
the cervix the animal heat melts the wax, releasing the sponge, which 
is then free to act. 

BRAN— FURFUR. (Not Official.) 

Description — The ground husk of the wheat grain, mixed usually 
with a small .proportion of starch. 

Medicinal Uses. — Bran is employed as an absorbent and dressing 
for compound fractures of the leg. Cheapness is one of its merits. 

ORDER V.— COLORING AGENTS. 

These are employed exclusively for pharmaceutical purposes. 
The following articles enter into official preparations, to which they 
are intended to communicate their peculiar color : — 

crocus— saffron. 

Description and Habitat. — This is the stigmas of Crocus sativus 
[Nat. Ord. Iridese), a small perennial plant, a native of Greece and Asia 
Minor, but now cultivated all over Europe and in Pennsylvania. 



ANTHELMINTICS. 599 

Properties and Constituent. — The stigmas are an inch or more 
in length, of a rich deep orange color, a peculiar aromatic odor and a 
warm, pungent, bitter taste ; they contain a principle termed saffranin 
or polychroit (C 48 H 60 O 18 ). 

Effects and Uses. — Saffron is now admitted to possess little, if 
any, medicinal activity, and is used only to impart color and flavor to 
official preparations. 

Administration. — The tincture (tinctura croci) contains 10 per 
cent, of saffron ; dose f5i-iij. 

SANTALUM RUBRUM-RED SAUNDERS. 

Description and Habitat. — This is the wood of Pterocarpus 
santalinus, a large tree of India and Ceylon (Nat. Ord. Leguminosse). 

Properties and Constituents. — It comes in roundish or angular 
billets, internally of a blood-red color, externally brown, of little smell 
or taste; in the shops it is found in the form of chips, raspings or 
coarse powder. It contains a resinoid matter, santal (C 8 H 6 3 ), ptero- 
carpin (C 17 H 16 5 ) and santalic acid. 

Effects and Uses. — It is employed solely to give color to spirits, 

tinctures, etc. 

coccus— cochineal. 

Habitat. — This is an insect, termed Coccus cacti [Class, Insecta ; 
Ord. Hemiptera), of Mexico and Central America, naturalized in Ten- 
erifife and other places. 

Properties, Varieties and Constituent. — The female insect, 
dried, constitutes the article of the shops. It occurs in the form of 
roundish or somewhat angular grains, about an eighth of an inch in 
diameter, convex on one side, concave or flat on the other, and 
wrinkled. Two varieties are distinguished, one reddish-gray, the 
other nearly black, known as silver grains and black grains. It has a 
faint, heavy odor and a bitter, slightly acidulous taste ; its red coloring 
principle is carminic acid (C 17 H 18 O 10 ). 

Effects and Uses. — It is employed chiefly to color tinctures, oint- 
ments, etc. 

ORDER VI.— ANTHELMINTICS. 
Anthelmintics are medicines which promote the destruction and 
expulsion of worms from the alimentary canal. When a medicine 
simply causes the expulsion of the parasite it is called a Vermifuge ; 
when it causes the death of the worm, a Vermicide. The vermifuges 
are spigelia, calomel and the hydragogue purgatives ; the vermicides, 
chenopodium, santonica, aspidium, granatum, oleum terebinthince, cusso, 
kamala and pepo. They act in different ways ; some weaken or destroy 



600 



MATERIA MEDIC A AND THERAPEUTICS. 



the worms by a direct poisonous influence, as male-fern, and others by- 
mechanical means, notably kamala. The hydragogue cathartics exert 
an anthelmintic effect by the increased peristalsis and purgation which 
they induce in and from the intestinal canal. As thread-worms chiefly 
occupy the rectum, enemata are used to destroy them, as quassia in- 
fusion (q. v.), cod-liver oil (q. v.), and carbolic acid (q. v.). See p. 376. 

SPIGELIA— PINKROOT. 

Description and Habitat. — Spigelia is the rhizome and roots 
of Spigelia marilandica, or Carolina Pink {Nat. Ord. Loganiacese), an 

Fig. 61. 




SPIGELIA MARILANDICA. 



ANTHELMINTICS— PINKR OOT. 601 

herbaceous, indigenous plant, found chiefly in our Southern and South- 
western States. 

Properties and Constituents. — The rhizome and roots, as 
found in the shops, the former being of horizontal growth, consist of 
numerous slender, wrinkled, branching, brownish fibres attached to a 
dark-brown caudex, and have a faint, peculiar smell and a sweetish, 
slightly bitter taste ; their activity is diminished by time. Boiling 
water extracts their virtues, which are thought to depend upon 
a bitter-principle ; it contains also volatile oil, resin, a little tannic 
acid, etc. 

Physiological Effects. — In ordinary doses spigelia often proves 
anthelmintic without any sensible effect on the system. In larger doses 
it purges and sometimes vomits ; and in excessive doses it operates as 
a narcotic, producing vertigo, dilated pupils, flushing of the face, etc. 
The following results were obtained by Hare* with spigelia on dogs. 
Three ounces of the fluid extract caused constant retching, pupillary 
dilatation, internal strabismus, rapid respiration, progressive muscular 
palsy, coma and death. Injected into the veins it slowed the heart's 
action, the retardation being chiefly due to central inhibitory stimula- 
tion. As death approaches, its depressing action on the respiratory 
centre is marked. It is less apt to occasion narcotic effects when it acts 
on the bowels, and hence it is usually combined with or followed by 
cathartics. 

Medicinal Uses. — As an anthelmintic against lumbrici (or round- 
worms) it is considered one of the most reliable articles we possess. 
Before its exhibition a restricted diet and an active cathartic should be 
prescribed. 

Administration. — Dose of the powdered root, 5j-ij for an adult; 
for a child three or four years old, gr. x-xx to be repeated night and 
morning for three or four days, and followed by a brisk cathartic ; 
calomel is sometimes combined with it. The fluid extract (extractum 
spigelice fluiduin) may be given in the dose of f5j or more ; to a child 
two years old, ten drops may be given in aromatic elixir. Under the 
name of worm-tea, preparations containing spigelia and cathartics are 
kept in the shops, as in the following formula : spigelia, §ss ; manna, 
§j ; senna and fennel, each 5ij ; savine, gr. xl ; to be infused in Oj of 
boiling water, and f§ss given to a child two years old, t. d. 



* Med. News, March 12, 1887. 






602 



MATERIA MEDICA AND THERAPEUTICS. 



CHENOPODIUM-AMERICAN WORMSEED. 

Description and Habitat. — Chenopodium is the fruit of Che- 
nopodium ambrosioides, or Jerusalem Oak (Nat. Ord. Chenopodiacese), 
an indigenous, herbaceous, perennial plant (found most abundantly in 
the Southern States), from two to five feet high, with alternate, oblong- 

Fig. 62. 




CHENOPODIUM AMBROSIOIDES. 



lanceolate, sinuated and toothed yellowish-green leaves, with numer- 
ous small flowers of the same color arranged in long terminal panicles. 
Properties and Constituents. — Chenopodium, as found in the 
shops, is in small spherical grains, not longer than a pin's head, of a 
dull greenish-yellow or brownish color, a peculiar offensive smell, and 
a rather aromatic, pungent taste. Their sensible and medicinal pro- 
perties are owing to a volatile oil (oleum chenopodii), obtained by 
distillation, a yellowish-brown oil, having the odor of the plant. 



ANTHELMINTICS— SANTONICA, 603 

Effects and Uses. — Chenopodium is a very efficient anthelmintic, 
particularly adapted to the expulsion of lumbrici from children. 

Administration. — Dose, gr. xx-xl for a child two or three years 
old, in molasses, night and morning, for three or four days, to be 
followed by a brisk cathartic. The oil [oleum chenopodii) is used ; 
dose, gtt. v-x, (child or adult), in emulsion with sugar or in capsules. 
A decoction can be made with water, or a popular form is 5/^-j of the 
seed in molasses. 

SANTONICA. 

Description and Habitat. — The unexpanded flower-heads of 
Artemisia maritima (Nat. Ord. Compositae), a native of Persia, and of 
other species of artemisia, are used as an anthelmintic (in the dose 
of gr. x-xxx), under the name of Levant Wormseed. 

Properties and Constituents. — They resemble small seed in 
appearance, are about a line in length, oval, obtuse at both ends, of a 
greenish-brown color, a strong, somewhat terebinthinate odor, and a 
bitter, camphoraceous taste. They contain volatile oil, resin, and a 
peculiar principle termed santonin. 

Santoninum [Santonin] is a neutral principle (C 15 H 18 3 ), and 
occurs in colorless, shining, flattened prisms, without smell, nearly 
tasteless at first, but after a time bitter ; it becomes yellow on exposure 
to the light. It is nearly insoluble in cold water, soluble in 250 parts 
of boiling water, in 40 parts of cold and 3 parts of boiling alcohol, 
and in 160 parts of ether, and is readily soluble in chloroform. 

Physiological Effects. — Krauss * experimentally ascertained 
that it was absorbed by the blood, where it exists for a time unde- 
composed ; he states, too, that it affects the central nervous system, 
in small doses as a narcotic ; in large, as a tetanizer, the symptoms 
being (occasionally but not invariably) vomiting, giddiness, ocular 
scintillations, incoherence of ideas, stupor, coldness of the skin, with 
clammy perspiration, and, finally, tetanic convulsions. A remarkable 
effect produced by santonin, even in moderate amounts, is a change in 
the field of vision, so that objects are seen as if through a yellow 
medium. When allowed to remain in the system, santonin is supposed 
to be converted into a substance termed xanthopsin, which is elimi- 
nated through the kidneys, producing a yellow discoloration of the 
urine, and probably it is this transformation which gives rise to the 

* Inaug. Diss. Tubingen, 1869, Ueb. d. Wirk. d. Santonins, etc. 



604 MATERIA MEDIC A AND THERAPEUTICS. 

poisonous symptoms occasionally noticed. Hence, santonin is best 
administered with calomel or other purgatives. W. G. Smith * detected 
santonin in his own urine, but he could not find it in the saliva. Some 
persons are peculiarly susceptible to its effects. 

Toxicology. — In large doses it is capable of producing serious 
and sometimes fatal poisoning,f gr. yj having killed a child aged five 
years thirty-five minutes after ingestion. 

Medicinal Uses. — Santoninum is the anthelmintic constituent of 
santonica, and is a most efficient and preferred remedy for lumbrici. 
It should be followed in a few hours by castor-oil, or other pur- 
gative. 

Administration. — Dose, gr. ss-v two or three times a day, in 
the form of pill, powder or capsule. For a child : ^ Santonini, gr. 
iij ; calomel, gr. j ; sacch. albi, gr. x. M. S. — Ft. chart, no. vi, one 
every 3 hours till all are taken. Trochisci santonini contain about gr. 
y 2 each. 

ASPIDIUM— MALE FERN. 

Description and Habitat. — Aspidium Filix-mas or Dryopteris 
Felix-mas, or D. Marginalis [Nat. Ord. Filices) are plants found in 
both hemispheres, from Greenland to Natal, and from Japan to Peru* 
though not indigenous in the eastern United States. They have a 
perennial horizontal root, from which spring numerous annual, oval, 
lanceolate, acute, bright-green pinnate fronds or leaves, from a foot to 
four feet in height, grouped together in the form of a base; the leaflets 
are deeply lobate, oval, crenate at their edges, and gradually diminish 
from the base of the pinna to the apex. 

Properties and Constituents. — The rhizome is the portion used. 
It is a long, cylindrical caudex, covered with portions of the stipes, and 
as found in the shops it is generally broken into fragments of a brown 
color externally, internally yellowish-white or greenish, with a peculiar 
feeble odor and a sweetish, bitter, astringent, nauseous taste. It 
deteriorates by keeping. It contains filicic acid (C 14 H 16 5 ), on which 
its medicinal properties are said to depend ; also volatile oil, fixed oil, 
resin, tannic and gallic acids, etc. ; ether is the best solvent to extract 
its virtues. Besides the above, Daccomo % has isolated a waxy-sub- 



* Dublin Quart. Journ. of Med. Set., 1870, p. 296. 
t St. Thomas' Hosp. Reports, Vol. x. 

\ Annali di Chimica, Agosto, 1887, p. 69. An elaborate investigation. See also Am. 
Jour. Pharm., 1889, p. 144. 






ANTHELMINTICS— POMEGRANA TE. 605 

stance (C 13 H 26 0), aspidol (C 20 H 34 O), and two resins. He failed to find 
the essential oil obtained by Schoonbroodt* 

Effects and Uses. — Aspidium possesses tonic and astringent 
properties ; but its chief use is to cause the expulsion of tcenia, which 
it destroys by a specific action. J. Harley f states that it does not kill 
the entozoon, but simply detaches it from the intestinal wall, and causes 
its evacuation by the force of the peristaltic contractions induced by 
its action. Its efficacy as a vermicide has been long and well attested. 

Toxicology. — A fatal case of poisoning J by aspidium has been 
reported, with symptoms of choleraic diarrhoea. The patient was 
given 5]}4 of an ethereal extract by mistake. The post-mortem 
appearances were intense congestion of the stomach, with ecchymoses 
beneath the mucous membrane and blood-clots on the mucous surface. 
Prevost and Binet § state that it kills animals by paralysis of heart and 
respiration. 

Administration. — Dose, of the powder, 5j^iij, in emulsion night 
and morning for one or two days. The oleoresin (oleoresina aspidii) is 
the best preparation ; it is a dark, thick liquid, of a bitterish, nauseous, 
slightly acrid taste; dose, f5ss-j, in emulsion, pills or capsules, night 
and morning for a day or two, to be followed by a cathartic. As a 
sediment is deposited from it on standing, it should be shaken before 
use. The administration of the tseniacide agents should always be 
preceded by a twenty-four hours' fast. 

GRANATUM— POM EGRANATE. 

Description. — The bark of the root of Punica Granatum {Nat. 
Ord. Lythrariae) is used for the expulsion of taenia. 

Chemical Constituent. — It contains pelletierine\\ (C 8 H 15 NO), a 
colorless liquid, forming crystalline salts with acids. 

Effects and Uses. — Pelletierine in large doses is said to cause 
paralysis of the motor-nerves, without affecting sensation, and to dilate 
the capillaries. Pomegranate is an active tceniacide, but is apt to cause 
nausea and sometimes vomiting. Pelletierine tannate may be given in 
doses of gr. v-xv on an empty stomach, and is best preceded by a 
purgative. If the drug do not move the bowels, a brisk cathartic 

* Jour, de Med. Chir. et de Pharm., Bruxelles, 1868, p. 64. 

t " RoyWs Mat. Med.," p. 370. 

% Lancet, Oct. 1882, p. 630. 

I Lancet, July 18, 1 89 1. 

|| Bull. Gen. de Therap., xcvm, p. 316, Tanret. 



606 MATERIA MEDICA AND THERAPEUTICS. 

should follow its administration. Berenger-Feraud * observed that 
the exhibition of a drastic, as jalap, or scammony, with pelletierine, 
decidedly aided this agent in the expulsion of tcenia. 

Fig. 63. 




PUNICA GRANATUM, ROOT-BARK. 

Besides its tceniacide action, granatum is a powerful styptic. 
Administration. — It is given in decoction (Sij to water Oij, boiled 
to Oj) ; dose, f5ij or more. 

Oleum Terebinthinae (Oil of Turpentine) (see p. 404) is used as a 
remedy for tcenia, round and thread-worms. Dose, f &/§-%, in emulsion 
or capsules ; 1^ 01. terebinthinae, f 5iss ; mistura. amygdalae, fgiss. 
M. S. — One dose, followed by castor-oil. An objection to its use is 
renal irritation. 

Calomel (see p. 450) is an anthelmintic, when given in cathartic 
doses, against round and thread-worms. 

Cusso (Kousso). — Description and Habitat. — The female in- 
florescence of Hagenia abyssinica (Nat. Ord. Rosaceee), a native of 
Abyssinia, has been introduced into European practice as an anthel- 
mintic, under the name of Kousso, or Brayera. 

Properties and Constituents. — They occur in broken, com- 
pressed clusters of a greenish-yellow color, a fragrant balsamic odor, 
and a faint taste which after a time becomes acrid and disagreeable. 
They yield gtim, resin, fatty matter, tannic acid, and about three per 
cent, of a peculiar principle termed koossin (C 31 H 38 O 10 ? ), a yellow-white 
crystalline resin, without smell or taste, to which its anthelmintic pro- 
perties are attributed (Bedellf). 

Effects and Uses. — In large doses cusso may cause vomiting, 
colic and diarrhoea. It is used against tcenia, which it kills, and 
should be followed by an active purge. Cusso is given upon an empty 
stomach, after a previous evacuation of the bowels. 

* Bull. Gin. de Thirap., Aofit isieme, p. 120, 1888. 

f " Biennial Retrosp., etc., New Syd. Soc." 1867-8, p. 475. 



» ANTHELMINTICS— PUMPKIN-SEED. 607 

Administration. — Extractum cusso fluidum {fluid extract of 
kousso); dose, f5ij-iv. Of koossin, gr. xv-xxx. 

KAMALA-(FORMERLY CALLED ROTTLERA.) 

Description and Habitat. — This is the glands and hairs 
obtained from the capsules of Mallotus philippinensis {Nat. Ord. 
Euphorbiacese), a small evergreen tree of Hindostan and the East 
India islands. 

Properties and Constituents. — It is an orange-red, granular, 
inflammable powder, with little smell or taste, insoluble in cold, and 
nearly so in boiling water, forming, with alcohol, ether or chloroform, 
red solutions, due to the extraction of the resin. It consists chiefly of 
resinous substances, to one of which, soluble in ether, and considered 
the active constituent, the name of rottlerin (C 22 H 20 O 6 ?) has been given. 

Effects and Uses. — Kamala is a gastro-intestinal irritant. It is 
a highly-esteemed tceniacide in India, and has been introduced as such 
into Europe and our own country. 

Administration. — Dose of the powder, 5i-ij, suspended in syrup. 
A tincture (§vj to alcohol Oj) is given in the dose of f3j-jv. Castor- 
oil should be taken after the medicine. 

PEPO— PUMPKIN-SEE D. 

Description. — The seed of Cucurbita Pepo, or common Pump- 
kin {Nat. Ord. Cucurbitaceae). 

Fig. 64. 




CUCURBITA PEPO. 

A. Divided. B. Entire. 

Properties and Constituents.— The seeds are oval, flattish, 
grooved, 9 lines long by 5 or 6 in breadth, of a light brownish-white 
color, a sweetish, oily taste, and an aromatic smell. They owe their 
activity to a principle soluble in ether, chloroform, and especially 
alcohol. 



608 MATERIA MEDICA AND THERAPEUTICS. 

Effects and Uses. — This is probably the most efficacious remedy 
known for the destruction and expulsion of tape-worm. 

Administration. — Dose, Sj-ij of the fresh seeds, deprived of their 
outer envelope, beaten to a paste with finely-powdered sugar, and 
diluted with water or milk, may be taken after a twenty-four hours' 
fast, and followed in two or three hours by a dose of castor-oil. A 
fluid extract, made with alcohol and glycerin, is probably the best 
preparation; dose f5ss-j. 



APPENDIX. 



I. DIETARY FOR THE SICK. 

(From Burnet's Foods and Dietaries). 
BEEF ESSENCE. 

Cut up in small pieces one pound of lean beef, from the sirloin or 
rump, and place it in a covered saucepan, with half a pint of cold 
water, by the side of the fire for four or five hours, then allow it to 
simmer gently for two hours. Skim it well and serve. 

BEEF TEA. 

Cut up a pound of lean beef into pieces about the size of dice ; 
put them into a covered jar with two pints of cold water and a pinch 
or two of salt. Let it warm gradually and simmer for a couple of 
hours, care being taken not to allow it to reach the boiling point. 

CHICKEN TEA. 

Cut up a fowl in small pieces. Put it into an earthen vessel with 
some salt and three pints of water ; let it boil three hours, allow it to 
cool and skim off the fat. 

EGG AND SHERRY. 

Beat up with a fork an egg till it froths ; add a lump of sugar and 
two tablespoonfuls of water; mix well, pour in a wineglassful of sherry 
and serve before it gets flat. 

EGG AND BRANDY. 

Beat up three eggs to a froth in four ounces of cold water ; add 
two or three lumps of sugar and pour in four ounces of brandy, stirring 
all the time. A portion of this to be given at a time. 

ARROWROOT. 

Mix two teaspoonfuls of the best arrowroot with half a wine- 
glass of cold water ; add a pint of boiling water ; put it into an 
39 609 



610 APPENDIX. 

enamelled saucepan and stir over the fire for three minutes. Sweeten 
with three teaspoonfuls of sifted loaf-sugar. 

RICE AND MILK. 

To a quart of milk add a quarter of a pound of rice which has 
been well washed; simmer for an hour, stirring very frequently. 
Flavor with cinnamon or lemon-peel, and just before serving sweeten 
to taste. 

NOURISHING SOUP. 

Take a pound of good lean beef and a pound of mutton, and cut 
them into pieces the size of dice. Take a calf's foot and split it. Put 
them into a jar with two quarts of cold water, and let them simmer in 
the oven for five or six hours, adding about the middle of that time 
another quart of water and some simple seasoning. When the quan- 
tity is reduced to one and a half quarts take it out of the oven and 
strain. When cold remove the fat. This soup may be taken cold, or 
may be warmed up with a little pepper and salt. 

PEPTONIZED MILK. 

A pint of milk is diluted with a quarter of a pint of water, and 
heated to a temperature of about 140 F. Should no thermometer be 
at hand, the diluted milk may be divided into equal portions, one of 
which is heated to the boiling point, and added to the cold portion, 
when the mixture will be of the required temperature. Two teaspoon- 
fuls of the liquor pancreaticus and ten grains of sodium bicarbonate 
are then added to the warm milk. The mixture is poured into a cov- 
ered jug, and the jug is placed in a warm situation under a " cosey " in 
order to keep up the heat. At the end of an hour the product is boiled 
for two or three minutes. It can then be used as ordinary milk. 

PEPTONIZED BEEF TEA. 

A pound of thirrly-minced lean beef is mixed with a pint of water, 
and ten grains of sodium bicarbonate are added thereto. The mixture 
is then simmered for an hour and a half in a covered saucepan. The 
resulting beef-tea is decanted off into a covered jug. The undissolved 
beef residue is then beaten up with a spoon into a pulp and added to 
the beef-tea in a covered jug. When the mixture has cooled down to 
about 140 F. (or when it is cool enough to be tolerated in the mouth), 
a tablespoonful of liquor pancreaticus is added, and the whole well 



APPENDIX. 611 

stirred together. The covered jug is then kept under a " cosey " for 
two hours, and agitated occasionally. At the end of this time the con- 
tents of the jug are boiled briskly for two or three minutes and finally 
strained. The product is then ready for use. 

PEPTONIZED ENEMATA. 

Pancreatic extract is peculiarly adapted for administration with 
nutritive enemata. The enemata may be prepared in the usual way 
with a mixture of milk and gruel, or milk-gruel and beef-tea. A des- 
sertspoonful of liquor pancreaticus is added to it just before adminis- 
tration. 

MILK DIET. 

From two to three pints of milk daily will in most cases be suffi- 
cient, and it should be given well diluted (as with carbonated waters, 
see p. 572) and at intervals of four to six hours. In chronic and 
debilitating diseases a more liberal allowance will be necessary, and 
broths and soups will have to be added to the list. Koumis, butter- 
milk and skimmed milk are likewise serviceable. 

For Barley Water see p. 576 ; Linseed Tea, p. 575, and Lemonade, 
p. 259. 



612 APPENDIX. 



II. SIGNS AND ABBREVIATIONS USED IN 
PRESCRIPTIONS. 

R , Recipe, take, 
aa, Ana (ava), of each, 
lb, Libra, librce, a pound, pounds. 
3j , Uncia, uncice, an ounce, ounces. 
g, Drachma, drachmce, a drachm, drachms. 
J^ , Scrupulus, scrupuli, a scruple, scruples. 
O, Octarius, octarii, a pint, pints, 
f ^ , Fluiduncia, fluiduncice , a fluidounce, fluidounces. 
f 5J, Fluidrachma,Jluidrachmce, a fluidrachm, fluidrachms. 
1TL, Minitnum, minima, a minim, minims. 

Ad, two. 

Ad 2 Vic, v4</ duas vices, at two takings. 

Ad Lib., Ad libitum, at pleasure. 

Add., Adde, addantur, add, let be added. 

Altern. Horis, Alternis horis, every other hour. 

Aq. Destil. , Aqua destillata, distilled water. 

Aq. Ferv., Aqua fervens, hot water. 

Aq. Fluvial., Aqua Fluvialis, river- water. 

Aq. Font , Aqua fontana, spring-water. 

Aq. Pluv., Aqua pluvialis, rain-water. 

Bis, twice. 

Bis Ind., Bis indies, twice a day. 

Bull., Bulliat, bulliant,let it or them boil. 

Cap., Capiat, capiendum, let the patient take it ; it must be taken. 

Charta, Chartula^ a paper or a small paper; chartae, papers. 

CoCHLEAT., Cochleatim, by spoonfuls. 

Coch. Mag., Cochleare magnum, a tablespoonful. 

Coch. Med., Cochleare medium, a dessertspoonful. 

Coch. Parv., Cochleare parvum, a teaspoonful. 

Col., Cola, coletur, strain, let it be strained. 

Collyr., Collyrium, an eye-water. 

Comp., Compositus, compounded. 

Cong., Congius, congii, a gallon, gallons. 

C. M. S., Cras mane swnendus, to be taken to-morrow morning. 

C. N., Cras node, to morrow night. 

Cum, with. 

Decoc, Decoctum, a decoction. 

De D. IN D., De die in diem, from day to day. 

Dieb. Altern, Diebus alternis, every other day. 

DlL., Dilue, dilutus, dilute, diluted. 



APPENDIX. 613 

Dim., Dimidius, one-half. 

Div. , Divide, divide. . 

D., Dosis, a dose. 

Elec, Electuarium, an electuary. 

Enem., Enema, enetnata, a clyster, clysters. 

Et, and. 

Exhib., Exhibeatur, let it be administered. 

F. PL, Fiat haustus, let a draught be made. 

FlL., Fi/tra, filter. 

Ft., Fiat, fiant, let there be made. 

Garg., Gargarysma, a gargle. 

Gr. , Granum, grana, a grain, grains. 

Gtt., Gutta, guttce, a drop, drops. 

Guttat., Guttatim, by drops. 

Haust., Haustus , a draught. 

In, in. 

Ind., Indies, daily. 

Inf., Infunde, pour in. 

Infus., Infusum, an infusion. 

Inj., Injiciatur, let it be injected. 

Jul., Julepus, julepu7n, a julep. 

M., Misce, mix. 

Macera, macerate. 

Mane, in the morning. 

Misce, mix. 

Mist., Mistura, a mixture. 

Mic. Pan., Mica panis , crumb of bread. 

No., Numero, in number. 

Non, not. 

Omn. Hor., Omni hord, every hour. 

Omn. Bid., Omni biduo, every two days. 

Omn. Bih. , Omni bihora, every two hours. 

Omn. Man., Omni mane, every morning. 

Omn. Nocte, Omni node, every night. 

Omn. Quadr. Hor. Omni quadrante horcz, every quarter of an hour. 

Ph., Pharmacopoeia. 

Pocul., Poculum, a cup. 

P. R. N., Fro re nata, as the symptoms may call for. 

Pulv. , Pulvis, a powder. 

Q. P., Quantum placeat, as much as you please. 

Q. S., Quantum sujfLciat, enough. 

Quater, four times. 

QuiNQUE, five times. 

Quor., Quorum, of which. 

Redig. in Pulv., Redigatur in pulverem, let it be reduced to powder. 

Repet. , Repetatur, repetantur, let it or them be repeated. 

S., Signa, write (mark or label). 

S. A., Secundum artem, according to art. 

Semih., Semihora, half an hour. 

Semel, once. 



614 APPENDIX. 

Sexies, six times. 

Sign., Signatura, a label. 

Ss., Semis, a half. 

Solutio, solution. 

Solve, dissolve. 

Stat., Statim, immediately. 

Sum., Sume, sumendus, let it be taken. 

Tabel., Tabella, a lozenge. 

Talis, such. 

Ter, thrice. 

Ter in Dies, thrice daily. 

Tere, rub. 

Troch. , Trochiscus, trochisci, a lozenge, lozenges. 

Trit. , Tritura, triturate. 

Ungt., Unguentum, an ointment. 



APPENDIX. 



615 



III. TABLE OF DOSES FOR ADULTS. 



To children {see Dr. Cowling's Rule, p. 72) the following proportions may be given 
except in the case of narcotics and laxatives ; of the latter doses greater than the usual pro- 
portion for age are well borne. 



For a child of I month 



> 20 



that of an adult. 



For a child of 6 months, ^ that of an adult. 

For a child of I year, y% that of an adult. 

For a child of 2 years, y^ that of an adult. 

For a child of 3 years, \ that of an adult. 

For a child of 5 years, T 3 7 that of an adult. 

For a child of 8 years, ^ that of an adult. 

For a child of 10 years, ■§ that of an adult. 

For a child of 12 years, % that of an adult. 

For a child of 15 years, | that of an adult. Beyond this age, adult doses 
At 50 years, f ; 60, f ; and 80, % of the adult dose. 
For the hypodermic proportion, see p. 74; of the quantity by the rectum, p. 79. 



Page. 



Apothecaries' 
Measure. 



Metric System. 



Maximum 
quantity in 
! 24 hours. 



ABSINTHIUM 

infusum absinthii (not official) 

ACACIA 

mucilago acaciae 

syrupus acacise 

ACETANILIDUM .'.... 



ACIDA 

acidum aceticum dilutum . . . 

acidum benzoicum 

acidum boricum 

acidum carbolicum 

acidum citricum 

acidum gallicum 

acidum hydrobromicum dilutum 
acidum hydrochloricum dilutum 
acidum hydrocyanicum dilutum 

acidum lacticum s 

acidum nitricum dilutum . . . 
acidum nitro-hydrochloricum . . 
acidum nitro-hydrochloricum di- 
lutum 

acidum phosphoricum dilutum . 
acidum salicylicum 

sulphuricum aromaticum . 
sulphuricum dilutum . . . 

tannicum 

trochisci acidi tannici . . . 
tartaricum 



53 



573 
573 

572 



258 
5 2 4 
506 
515 

259 
182 
302 
173 
3°9 
176 
172 
174 

174 
175 
530 

171 

182 
182 
259 



fgss-i 



-30.0 gm. 



as vehicles 

gr. iv-viij ; 0.26—0.52 gm. gr. 45 



gr. v-xx 
gr. v-x 
gr. i-ij 
gr. v— xx 
gr. ij-v 
fffss-ij 
Tflv-xx 

TTLi-iJ 

YT[v-xxx 

TTtij-xx 

THiJ-v 

Tn_x-xxx 

tt^x-xxx 

gr. i-iv 

1-4 
gr. v-xx 



3-75-7-5 g m - 
0-32-1 -3 g m - 
0.32-0.65 gm. 
0.07-0.13 gm. 

0.32-1.3 g m - 
0.13-0.32 gm. 

i I -90-7-5 g m - 
1 0.3-1.25 gm. 
! 0.06-0.12 gm. 
O.6-1.90 gm. 
j 0.1 2-1. 25 gm. 
j 0.12-0.3 gm. 

0.12-0.6 gm. 
0.6-1.90 gm. 
0.65-3.9 gm- 



0.6-1.90 gm. 
0.07-0.26 gm. 

0.32-1.3 g m - 



gr- IV. 



616 



APPENDIX. 



ACONITUM 

aconitine (not official) 
extractum aconiti . . 
extractura aconiti fluidum 
tinctura aconiti .... 



ADONIDIN (not official) . 

^THER (ether) 

aceticus 

aetheris compositus spiritus 
aetheris nitrosi spiritus 

ALLIUM 

syrupus allii 

ALMOND PREPARATIONS 

(see Amygdalae Pr^parata). 

ALOES PURIFICATA .... 
aloin 

extractum aloes 

pilulae aloes 

pilulae aloes et asafcetidae - . . 

pilulae aloes et ferri 

pilulae aloes et mastiches . . . 
pilulae aloes et myrrhae .... 

tinctura aloes 1 

tinctura aloes et myrrhae . . J 

ALTHAEA 

syrupus altheae 

ALUMEN 

exsiccatum 

AMMONIACUM 

emulsum ammoniaci . . . . 

AMMONII PR^PARATA . . 

benzoas 

bromidum 

carbonas . 

chloridum 

iodidum 

aqua ammoniae 

liquor ammonii acetatis .... 

spiritus ammoniae 

spiritus ammoniae aromaticus . . 

AMYGDALiE PR^PARA ' A 
aqua amygdalae amarae .... 

emulsum amygdalae 

oleum amygdalae amarae .... 
oleum amygdalae expressum . . 
spiritus amygdalae amarae . . . 
syrupus amygdalae amarae . . . 

AMYL NITRIS . 

ANISUM 

oleum anisi 

spiritus anisi , . . , 




Apothecaries' 
Measure. 



g 1 "- SY0~T¥0 

gr. Vs- 1 / 
m/6-iij 
TTU- V 

gr. yi-y 2 

Vdi 5-30 
f3 ^"J 



404 131- 



Metric S3 T stem. 



O.O16-O.07 g m - 
0.0003 -0.002 8 gm. 
0.008-0.016 gm. 
O.010-0.18 gm. 
0.016-0.3 gm. 

0.008-0.03 gm. 

o- 55-3-4° g m - 
0.80-1.70 gm. 
0.55-3-40 gm. 
1.70-3.40 gm. 



5.0-20.0 gm. 



Maxim utn 

quantit3 r in 

24 hours. 



vA 



m* v 



357 


gr. v-x 


0.32-0.65 gm. 


357 


g r - 2VX 


0.0032-0.01 6 gm. 


357 


gr. l-v 


0.07-0.32 gm. 


357 


i-3 




357 


2-5 




357 


i-3 




357 


1-2 




357 


2-5 




357 


fsK-'j 


1.90-7.50 gm. 


577 






578 


ad libitum 




208 


gr. x-xxx 


0.65-1.95 gm. 


209 


gr. v-x 


0.32-0.65 gm. 


128 


gr. x-xx 


0.65-1.3 gm. 


128 


fZi-Z*A 


3-75~ I 5 gm- 


217,493 






525 


gr. v-xx 


0.32-1.3 gm. 


301 


gr. v-xxx 


0.32-1.95 g m - 


221 


gr. v-x 


0.32-0.65 gm. 


220 


gr. v-xxx 


0.32-1.95 gm. 


465 


gr. v-xv 


0.32-1.00 gm. 


218, 561 


f^ss-i 


0.28-0.80 gm. 


256 


15.0-30.0 gm. 


219 


m x-xxx 


O.55-I.70 gm. 


219-493 


fgss-i 


1.90-^.75 g m - 


311 


fgss 


15.0 gm. 


574 


fglj-lv 


7.5-15.0 gm. 


310 


WX-/2 


0.016-0.03 gm. 


334 


fSi-ffi 


3.40-27.0 gm. 


3ii 


f A [ ■ 


3-75 gm- 


3" 


f 3 ss -J 


2.50-5.00 gm. 


3*3 


vfiy 2 -i 


0.03—0.07 gm. 




ITLv-x 


0.28-0.55 gm. 


234 


f 3i-iJ 


3.40-6.75 gm. 



APPENDIX. 



617 



Page. 



Apothecaries' 
Measure. 



ANTHEMIS 

infusum anthemidis (not official) 

ANTIFEBRIN (see Acetanilid) 

ANTIMONII PRiEPARATA 
et potassii tartras (tartar emetic) 
antimonium sulphuratum 
pilulae antiraonii compositae 
pulvis antimonialis .... 
vinum antimonii 



ANTIPYRINE (not official) 
salicylate (not official) . . 

APIOL (not official) .... 

APOCYNUM 

extractum apocyni fluidum . 
infusion (not official) . . . 

APOMORPHINiE HYDRO 
CHLORAS 

hypodermically 

AQUA CHLORI 

ARBUTIN (see Uva Ursi.) 

ARGENTI PR.EPARATA . . 

iodidum 

nitras 

oxidum 



I 



ARNICA 

extractum arnicae radicis . 
extractum arnicae radicis fluidum 
tinctura arnicae radicis . . . 
tinctura arnicae florum . . . 

ARSENII PR^PARATA . , 

acidum arsenosum 

arseni iodidum 

liquor acidi arsenosi 

liquor arseni et hydrargyri iodidi 
liquor potassii arsenitis (Fowler's 

solution) 

liquor sodii arsenatis 

sodii arsenas 

ASAFCETIDA 

emulsum asafcetidae 

pilulae asafcetidae 

pilulae aloes et asafcetidae . . .. 
tinctura asafcetidae 



ASCLEPIAS 

extractum asclepiadis fluidum . . 

ASPIDIUM 

oleoresina aspidii 

ASPIDOSPERMA 

extractum aspidospermatis fluidum 

ATROPINE (see Belladonna) 



> Maximum 
Metric System. \ quantity in 
i 24 hours. 



LSI 



249 
252 
252 
252 
252 
252 

538 
538 

426 

395 
396 
396 



33o 
330 
500 



201 
205 
204 
205 

246 

247. 
247 

247 

469 
475 
477 
477 
478 

476 
477 
477 
127 
127 
127 
127 
127 

386 

605 
605 



f£ij 



gr. X-iJ 
gr. i-iij 

I- 3 
gr. iij-viij 
YT^x-xxx 

gr. v-gi 

gr. xv 

f 5f ij-jv 



60.0 gm. 



0.016-0. 13 gm. 
O.07-O.20 gm. 

0.20-0.52 gm. 
0.65-1.95 gm. 

0-3 2 -3-9 gm. 
1.0 gm. 

0.10-0.32 gm. 

I-90-3-75 g m - 
7.5-15.0 gm. 



gr. y$-% 

g r - 2W5 

! fs^- 1 ] i l -90-3-75 gm 

(unstable) 



gr- i-ij 

gr- ss-i \ 
gr. ss-i j 



gr. v-x 

TTLx-xx 

YT[ V— XXX 



T6-TT 

l 4-% 



gr. 

mi- 



TTLx-xx 

gr- tH 
gr. v-xx 
f^ss-j 

I to 4 
3 to 6 

f^ss-j 
^ss-j 



322 I tltxv-f^j 



0.07-0.13 gm. 
O.03-0.07 gm. 



0.32-0.65 gm. 
0.6-1.25 gm. 

0.3-1.90 gm. 



O.004-O.005 gm. 
0.016-0.008 gm. 
0.06-0.6 gm. 
0.28-1. 1 2 gm. 

0.06-0.6 gm. 
0.6-1. 12 gm. 
0.005-0.02 gm. 

0.32-1.3 gm. 
I5-30 gm. 



3-75-7-5 g m - 

i-9°-3-75 gm. 
3.9-1 1.65 gm. 
1-95-3-9 gm. 

0-9-3-75 gm. 



gr- 1Y. 



31, 



4-ij 



0.008-0.016 gm. gr. )yi 
0.0032-0.006 gm.. 



gr- "J 



gr- V 



tz l A 



618 



APPENDIX. 



AURANTII PRiEPARATA . . 

elixir aromaticum 

extractum aurantii amari fluidum 

oleum aurantii corticis 

spiritus aurantii 1 

spiritus aurantii compositus . ) 
syrupus aurantii 

AURI ET SODII CHLORIDUM 

BALSAMUM PERUVIANUM 

BALSAMUMTOLUTANUM . 
syrupus tolutanus 



Page. 



230 
231 

231 

231 



tinctura tolutana 



A «^5 eS ' i Metric System. 



Measure 



quantity in 
24 hours. 



as excipient 

f£ [ 3-75 gm. 

TT[ij-v 0.10-0.28 gm. 

f^ss-j 1.70-3.40 gm. 

as excipient 

g r - 3W0 0.0022-0.006 gm. gr. 3 

{ X l A- l A 1.20-2.50 gm. 

gr. x-xxx 0.65-I.95 gm. 



BASHAM'S MIXTURE . . . 

BELLADONNA (root or leaves) 

atropinse sulphas 

atropinse sulphas, hypodermically 
extractum belladonnae foliorum 

alcoholicum 

extractum belladonnae radicis 

fluidum 

tinctura belladonnae foliorum 

BENZOINUM 

tinctura benzoini 

tinctura benzoini composita . . 

BERBERINE (not official) . . 

BISMUTHI PR^PARATA . 
bismuthi et ammonii citras . . 

bismuthi subcarbonas 

bismuthi subnitras 

bismuth valerianate (not official) 

BRAYERA (see Cusso) 

BROWN MIXTURE 

(see Acacia) 

BRUCINE (see Nux Vomica) 

BRYONIA 

infusion of bryony (not official) 
tinctura bryoniae ....... 

BUCHU 

extractum buchu fluidum . . 
infusum buchu (not official) . 

CAFFEINA 

citrata 

citrata effervescens 

valerianate (not official) . . . 

CALAMUS ......... 

extractum calami fluidum . . 

CALCII PR^PARATA . . 

bromidum 

carbonas praecipitatus .... 



231 
23F 

458 

421 

422 
422 
422 

(seeFERJRI PR/EPARA^TA) 



fgi-iij 



5.0-15.0 gm. 

i 3-75-7-5 gm. 



104 

105 
105 

104 

104 
104 

420 
420) 

420 f 



gr-X 

mi- v 

TTLv-xxx 

gr. x-xxx 
f^ss-ij 



147 gr. 



0.016 gm. 

0.06-0.3 gm. 
0.3-1.90 gm. 

0.65-1.95 gm. 

I-90-7-5 g m - 

0.07-0.65 gm. 



205 
207 
206 \ 

205/ 

207 


gr. ij-iv 


0.13-0.26 gm. 


gr. v-xx 
gr- K-i 


0.32-1.3 gm. 
0.03-0.07 gm. 



363 
363 

416 
416 
416 



W ■ 

f^SS-j 



gr. xx-xxx 
f % ss-i 
f ! 



-1J 



} 134 g 



gr. J6-1J 



229 j gr. xx- 3 i 1.3-3-9 g m - 

229 j HXxx-f^i 1.25-3.75 gm. 

494 

301 gr. x-31 0.65-3.9 gm. 

495 gr- x-xxx 0.65-1.95 gm. 



gr. xv 



gr. j repeated 0.07 gm. 

gr- t^Wo jo.0006-0.001 1 gm. gr. 3 

gr- rio-rio 0.0005-0.0004 gm. 



gr- "J 



30.00 gm. 
i.9°-3-75g m - 

T. 3-1.95 gm. 

I-90-3-75 g m - 
30.00-60.0 gm. 



0.03-0.13 gm. gr. 22 



APPENDIX. 



619 




CALCII PRiEPARATA— Con'd 

chloridum 

hypophosphis 

lactophosphatis, syrup of . . . 

phosphas praecipitatus 

calx sulphurata ....... 

creta praeparata 

liquor calcis 

mistura cretae 

pulvis cretae compositus .... 

syrupus calcis 

syrupus hypophosphitum (in part 

calcium hypophosphite) . . 

trochisci cretae 

CALENDULA 

tinctura calendulse 

CALOMEL (See Hydrargyri 
Prgeparata) 

CALUMBA 

extractum calumbae fluidum . . 
tinctura calumbae ....... 

CAMBOGIA 

pilulse catharticae compositse . . 

CAMPHORA 

monobromata 

aqua camphorae 

camphoric acid 

Hope's camphor mixture (not 

official) 

spiritus camphorae 

CANNABIS INDICA 

extractum cannabis indicae . . . 
extractum cannabis indicae fluidum 
tinctura cannabis indicae . . . 

CANTHARIS 

tinctura cantharidis 

CAPSICUM 

extractum capsici fluidum . . 

oleoresina capsici 

tinctura capsici 

CARBO 

animalis purificatus .... 
%ni 

CARDAMOMUM 

tinctura cardamomi 

tinctura cardamomi composita 

CARUM 

oleum cari 

CARYOPHYLLUS 

oleum caryophylli 



480 
478-9 
478 
478 
505 
495 
495 
495 
495 
495 

479 
495 

385 
385 



147 
147 

147 

37i 
37i 
130 

J3* 

130 
130 



130 
113 

113 
U3 
"3 

400, 556 
400 

553, 223 

223 
223 
223 



597 I 
597 J 



Apothecaries' 
Measure. 



227 
227 



234 
i 226 



gr. v-xx 
gr. x-xxx 
f^i-iv 

gr. v-x 

gr- tV-X 
gr. x-xxx 

f ( ^ss-iv 
f^ss-i 
gr. x-xxx 

1-2 

gr. viij-^i 

f 3 s H 



gr. x-xxx 

f^ss-i 

fgi-iv. 

gr. iJ- v J 
i-3 

gr. v-xx 
gr. v-x 

fgss-j 

gr. ss-ij, or 
more 

gr. X 

TTli-xv 

ttlv-xxx 

gr. i-ij 

TH.V-XV 

gr. v-x 
gr. ss-j 



5i-iv 
gr. v-x 



mj-x 

gr. v-x 
TTtiij-vi 



Metric System. 



Maximum 

quantity in 

24 hours. 



0.32-1.3 gm. 

0.65-I.95 gm. 
5.0-20.0 gm. 
0.32-0.65 gm. 
0.006-0.016 gm 
0.65-1.95 g m 
15. 0-120.0 gm. 
15.0-30.0 gm. 
0.65-I.95 gm. 
2.50-10.0 gm. 



5.0-10.0 gm. 

o.52-3.9 gm. 
I.90-3.75 gm. 



O.65-1.95 gm. 

1 -90-3- 75 gm. 
3-75-I5-0 gm. 

0.13-0.39 g m - 



°.3 2 - r .3 gm. 
0.32-0.65 gm. 
30.0-60.0 gm. 
1.0-2.0 gm. 

15.0-30.0 gm. 
3-75 gm. 
0.03-0.13 gm, 

0.016 gm. 
0.06-0.9 g m - 
0.3-1.90 gm. 

0.07-0.13 gm. 
0.3-0-9 gm. 

0.32-0.65 gm. 
0.3-0.6 gm. 
0.03-0.07 gm. 
0.6-3.75 gm. 



3.9-15.5 gm. 

0.32-0.65 gm 
3.75-7.5 gm. 

0.055-0.55 gm. 

0.32-0.65 gm. 
0.16-0.32 gm. 



3#-i 



gr. 3 

f^iss 



620 



APPENDIX. 



Page. 



Apothecaries' 
Measure. 



CASCARILLA 

infusum cascarillas (not official) 

CASSIA FISTULA ... 



CASTANEA 

extractum castaneae fluidum 

CATECHU 

tinctura catechu composita . 

CAULOPHYLLUM . . . 

CERII PR^PARATA 

cerii nitras (not official) . . 
cerii oxalas 

CETRARIA 

decoctum cetrariae .... 



CHELIDONIUM 

CHENOPODIUM 

oleum chenopodii 

CHIMAPHILA 

extractum chimaphilae fluidum 

CHIRATA 

extractum chiratae fluidum . . 
tinctura chiratae 



CHLORAL 

CHLORALAMIDE (not official) 

CHLOROFORMUM ... 

aqua chloroformi 

chlorodyne (not official) .... 

emulsum chloroformi 

spiritus chloroformi 

CIMICIFUGA 

extractum cimicifugae 

extractum cimicifugae fluidum . 
tinctura cimicifugae 

CINCHONA 

extractum cinchonas 

extractum cinchonae fluidum . . 

infusum cinchonae 

quinine, official salts of ... . 

tinctura cinchonae ^ 

tinctura cinchonae composita I 
(Huxam's tincture) ... J 

CINNAMOMUM 

aqua cinnamomi 

oleum cinnamomi .... 
spiritus cinnamomi .... 
tinctura cinnamomi .... 



COCA 

extractum cocae fluidum . 
vinum cocae (not official) 



153 

153 

334 



191 

184 
184 

426 

207 

581 

366 

603 
603 

417 
419 

148 
148 

295 



122 
122 

123 
123 
123 

287 
287 
287 
287 
161 
161 
161 
161 
162-3-4 



gr. xx-^ss 

f^ss-ij 

gr. x-£ss 
f 3 i-iij 



i gr. i-iij 
J gr. i-v 

! ad libitum 

i 

! gr- x - Z 1 

gr. x-^ij 
tflv-x 

fgss-j 

lUv-xx 

gr. x-xxx 
gr. xv-xl 

TTLxV-f 3 5S 

fgj-iv 

f|\x-xxx 

fgss-j 

f^ss-j 

gr. xx- ^ i 
gr. x-xx 
f^SS-j 

gr. x-xxx 

fgii 

gr. i-xx 



161 | fgi-iv 



224 



135 
135 



gr. x-xxx 
ad libitum 

rrix-xx 

f 5 i-iij 

f^ss-ij 
f^i-iv 



i Maximum 
Metric System, j quantity in 
24 Hours. 



i-3-i-95g m - 
60.0 gm. 

3.9-31. 1 gm. 



I-90-7-5 g m - 
0.65-1.95 g m - 
3-7S- II - 2 5gm. 
0.07-0.32 gm. 



0.07-0.20 gm. 
0.07-0.32 gm. 



0.65-3.9 gm. 

0.65-7.80 gm. 
O.28-0.55 gm. 

I -9°-3-75 gm. 

0.3-1.25 gm. 
Q.3-3-75 gm- 
0.65-1.95 gm. 
1.0-2.6 gm. 

1.20-2.50 gm 
5-20 gm. 
0.6-1.90 gm. 
20-40 gm. 
2.50-5.0 gm. 

1-3-3-9 gm- 
0.65-I.3 gm. 
1 -90-375 gm. 
3-75-7-5 gm- 
3. 9-3 1. 1 gm. 
0.65-1.95 gm- 
3-75 gm. 
60.0 gm. 
0.07-1.3 gm. 

3-75-I5-0 gm. 

0.65-I.95 gm. 

0.055-0.10 gm. 
0.55-L 12 gm. 
3-75-U-25 gm. 

1.90-7.5 gm. 
3-75- I 5-°° gm- 



3 i5S 
f^jss 



3 il X 



APPENDIX. 



621 



Page. 



Apothecaries' 
Measure. 



Metric System. 



Maximum 

quantity in 

24 hours. 



COCAINE HYDROCHLORAS 
hypodermically 

CODEINA (see Opium) 

COLCHICUM 

colchicine (not official) .... 
extractum colchici radicis . , . I 
extractum colchici radicis fluidum i 
extractum colchici seminis fluidum 
tinctura colchici seminis . . . . 
vinum colchici radicis .... 
vinum colchici seminis .... 

COLOCYNTHIS 

extractum colocynthidis . . 
extractum colocynthidis composi- | 

turn '. I 

pilulae catharticae vegetabiles . . ' 

CO. CATHARTIC PILLS (see ! 
Cambogia) 

CONIUM 

conine (not official) .... 

extractum conii 

extractum conii fluidum . . . 

CONVALLARIA 

convallamarin (not official) 
extractum convallariae fluidum 

COPAIBA 

Chapman's mixture of . . . 

massa copaiba? 

oleum copaibae 

resina copaibae 

CORIANDRUM 

oleum coriandri 



CREOLIN (not official) . . . . 

CREOSOTUM 

aqua creosoti 

CROCUS 

tinctura croci 

CROTON OIL (see Ol. Tiglii] 

CUBEBA 

extractum cubebae fluidum . - 
oleoresina cubebae .... 

oleum cubebae 

tinctura cubebae 

trochisci cubebae . . 

CUPRI SULPHAS .... 

CURARINE (see Woorara) 

CUSSO (Brayera) 

extractum cusso fluidum 
koossin (not official) . . . 



141 

141 



394 
394 
394 
394 
394 
394 
394 
394 

37o 
37o 

37o 
370 



289 
290 
290 
290 

285 
285 

412 
412 
412 
412 
410 

234 
518 

5i7 

518 

599 



gr. 



y%- i A 



gr. lj-vnj 

g r - 50 

gr- H , 

J TTtiv-xij 

TTLx— xxx 

gr. v-x 

gr. v-x 
1-3 



gr. ss-j 

ss-i 



gr. 
gr- 
T»lij- 



gr- %-) 
tttv-xv 

TTLxx-f 3 j 

gr. v-xxx 
TUv-xv 

gr. i-v 

m v 

THi-iiJ 

fgi-iv 

fji-iij 



0.016-0.03 gm. 
0.008-0.016 gm. 



0.13-0.52 gm. 
0.0013 gm. 
0.07-0.13 gm. 

0.24-0.72 gm. 

o. 9-3- 75 gm. 
0.6-I.90 gm. 

°-9-3-75 gm. 
0.32-0.65 gm. 
0.03-0.13 gm. 

0.32-0.65 gm. 



0.03-0.07 gm. 
0.001-0.002 gm, 
0.03-0.07 gm. 
o. 12-0.3 gm. 

: 0.016-0.07 gm. 
0.3-1.0 gm. 

j 1. 1 2-3. 40 gm. 
J 7.5-15.0 gm. 
j 0.32-1.95 gm. 
! 0.28-0.80 gm. 
I 0.07-0.32 gm. 



0.10-0.28 gm. 
0.3 gm. 
0.06-0.18 gm. 
3-75-'5-°g m - 

3-75-"-25 gm. 



413 


3J-"j. 


3.9-11.65 gm. 


413 


Tl^ v-xxx 


l-9°-3-75 g m - 


413 


-3- I -9°gm. 


413 


TTLx-xv 


0.55-0.80 gm. 


413 


f^l-lj 


3-75-7-5 gm. 


414 


I-IO 




198 


gr. X-J 


0.016-0.07 gm. 
Large doses 
cause vomiting 


6O7 


f^ij-iv 


7.5-15.O gm. 


607 


gr. xv-xx 


1. 0-I.3 gm. 



gr- 5 

gr. xv-xx 
gr. x 



fgiv 

fgij-iv. 

gr- 22^ 
gr. iij-v 



gr. v-x 
gr- l A 

gr. v-x 

m*x 

gr. A l A 



THI5 



622 



APPENDIX. 



CYPRIPEDIUM 

extractum cypripedii fluidum . 

DATURINE (see Stramonium) 
DERMATOL (not official) . . 

DIGITALIS 

digitalin (not official) .... 

extractum digitalis 

extractum digitalis fluidum . 

infusum digitalis 

tinctura digitalis 

DIURETIN 




DONOVAN'S SOLUTION (see 

Arsenii Pr^parata) 

DOVER'S POWDER (see 
DUBOISINE (not official) . . . 

DULCAMARA 

extractum dulcamarae fluidum . 

ELATERINUM 

trituratio elaterini 



ELIXIR AROMATICUM (see 

AUR ANTIUM ) 

EMETINE (see Ipecacuanha) 

EPSOM SALT (see Magnesii 
Pr^eparata) 

ERGOT 

labor . 

in other affections .... 
ergotine (not official, Bonjean's) . 

extractum ergotse 

extractum ergotae fluidum . . . 
vinum ergotse 

ERIODICTYON . 

aromatic syrup (not official) . . 
extractum eriodictyi fluidum . . 

ESERINE (see Physostigma) 

EUGENOL (not official) . 

EUCALYPTUS ..... 

eucalyptol 

extractum eucalypti fluidum 
oleum eucalypti ... 

EUONYMUS 

euonymin (not official) . 
extractum euonymi . . . 

EUPATORIUM 

extractum eupatorii fluidum 
infusum eupatorii (not official) 

EXALGINE (not official) . . . 



133 



549 
281 
281 
281 
281 
281 
281 



"35 



Opium) 



115 

372 
372 



269 
274 
274 
275 
274 

274 

275 

153 

i54 
154 



547 

149 
150 
150 

150 

3 6 7 
368 
368 

151 
152 

152 



Apothecaries' 
Measure. 



TTLx-xx 

gr. v 
gr. i-ij 

s 1 - 200 5 
gr. %-Vz 
ttli-ij 

fglj-lV 



g r - Tiro 



_i i_ 

2012 



gr. v-xx 
gr. iij-x 
gr. ij-v 
gr. v— xv 

f 3H v 

flavoring ve- 
hicle 



trt^x-xi 

TTLv-x 

r^v-x 

gr. K-iiJ 
gr. iij-v 

f ^ ss-j 



523 gr 



Metric System. 


Maximum 

quantity in 

24 hours. 


O.6-I.25 gm. 




O.32 gm. 


3 SS 


0.07-0.13 gm. 
0.0003-0.0013 gm. 
0.016-0.03 gm. 
0.06-0.12 gm. 
7.5- T 5-00 gm. 
o- 3-3- 75 g m - 


gr- I5K 
gr- l A 

f^i-iij 
fgiss— ij 


0.65-1.3 gm. 


gr. 45-90 


0.0006 gm. 


gr- tV 


3-75 gm. 




0.0032-0.005 gm. 
0.016-0.07 gm. 


gr- Vi-% 


0.32-1.3 gm. 

0.20-0.65 gm. 
0.13-0.32 gm. 
0.32-1.00 gm. 

0-3-3-75 gm. 
3.75-15.0 gm. 




3-75 gm- 




1. 12-2.25 gm. 




0.28-0.55 gm. 

3-75 g m - 
0.28-0.55 gm. 




0.03-0.20 gm. 
0.20-0.32 gm. 




1.90-3.75 gm. 
60.0 gm. 




0.03-0.26 gm. 


gr. vi-x 



APPENDIX. 



623 




EXTRACTUM AROMATI 
CUM FLU1DUM 



FEL BOVIS 

purification 

FERRI PRiEPARATA . . 

carbonas saccharatus .... 

citras 

et ammonii citras 

et ammonii sulphas 

et ammonii tartras 

lactas 

hypophosphis 

iodidum saccharatum .... 

phosphas solubilis 

et potassii tartras 

pyrophosphas solubilis . . . 

et quininse citras 

et quininse citras solubilis . ■ . 

et strychninge citras 

sulphas .=>.... 

sulphas granulatus 

valerianas 

ferrum dialysatum (not official 

ferrum reductum 

liquor ferri acetatis 

liquor ferri et ammonii acetatis 

(Basham's) 

liquor ferri chloridi 

liquor ferri citratis 

liquor ferri nitratis 

liquor ferri subsulphatis .... 

massa ferri carbonatis 

mistura ferri composita .... 

pilulse ferri carbonatis 

pilulse ferri iodidi 

syrupus ferri iodidi 

syrupus ferri quininse et strych- 

ninse phosphatum 

tinctura ferri chloridi 

trochisci ferri 

vinum ferri amarum 

vinum ferri citras 

FICUS (see Confectio Senn^e) . 

FCENICULUM 

aqua fceniculi ") 

oleum fceniculi j 

FOWLER'S SOLUTION (see 

Arsenii Pr^eparata) 

FRANGULA 

extractum frangulse fluidum . . 
syrup of frangula (not official) , 

GALLA 

tinctura gallse 



167 

427 
43° 

435 \ 
436/ 
43 6 
437 
43 6 
435 
434 
435 
434 
435 
436 
43 6 
43 6 
43i 
43i 
437 
437 
429 
435 

434 
432 
435 
435 
432 
43° 
43° 
43o 
434 
434 

43 6 
433 
43o 

436 1 
436/ 

333 



2.34 



359 
360 
360 



f3jss-j 



:8 3 
:8 4 




Maximum 

quantity in 

24 hours. 



15-3° g m - 



gr. v-x 


0.32-0.65 gm 


gr. v-xxx 


°-3 2 -i.95 g m 


gr. v-x 


0.32-0.65 gm 


gr. x-xv 


0.65-1.00 gm 



gr. v— x 
gr. x-xxx 

gr. ij-v 

gr. v-x 
gr. ij-iij 
gr. ss-iij 
gr. i-iij 

mxv-f^i 

gr. v-x 
Tt^x-xxx 

fgss-j 

Xf[^ x-xxx 

rilx-xx 

tTLv-xv 

gr. v-xx 
gr. v-x 

YT[ x-xxx 

each contains 



f^i-ij 



f^ss-ij 

ITLv-xv 



fgss-i 

gr. x-xx 
f 5 i-iij 



0.65-1.95 gm. 

0.32-0.65 gm. 
0.65-1.95 gm. 

0.13-0.32 gm. 

0.32-0.65 gm. 

p. 13-0. 20 gm. 

0.03-0.20 gm. 

0.07-0.20 gm. 
1-00-3.75 gm. 
0.32-0.65 gm. 
0.6-1.90 gm. 

15.0-30.00 gm. 
0.12-0.36 gm. 
0.6-I.90 gm. 
0.6-1.25 gm. 
°-3-o.9g m - 
0.32-1.3 g m - 
30.0-60.0 gm. 
0.32-0.65 gm. 

0.40-5.00 gm. 

5.00-10.00 gm. 
0.6-1.90 gm. 
gr. v of iron 

3-75-7-5 gm- 



15-60.0 gm. 
o. 28-0. 80 gm. 



1 -90-3-75 g m - 
5.00-10.0 gm. 

0.65-I.3 gm. 

3.75-I I.25 gm. 



624 



APPENDIX. 



Page. 


Apothecaries' 
Measure. 


Metric System. 


Maximum. 

quantity in 

24 hours. 


GAULTHERIA (not official) . . 
aqua gaultheriae (not official ) . . 
oleum gaultheriae (methyl sali- 

cylas) 

spiritus gaultheriae 


229 
230 

230 
230 


as vehicle 

TTlv-x 

f^ss-i 


0.28^.55 gm. 
I.70-3.40 gm. 




GELSEMIUM 

extractum gelsemii fluidum . . 


315 
317 


mv-x 


0.3-O.6 gm. 




gelsemine (not official) .... 


317 


g r - eWo 


f 0.0011 

1 0.0032 § m - 




tinctura gelsemii 


317 


tHv-xx 


0.3-1-25 gm. 


f^ss-j 


GENTIANA . . .... 


146 
146 
146 
146 


gr. x- 5 ss 
gr. x-^ss 

f^-ij 
fgi-ij 


0.65-1.95 gm. 
0.65-1.95 gm. 
3-75-7-5 g m - 
375-7-5 gm. 




extractum gentianae 

extractum gentianae fluidum 
tinctura gentianae composita . . 




GERANIUM 

decoctum geranii (not official) . 
extractum geranii fluidum . . . 


188 
188 

188 


gr. x-xx 

f^ss-j 


0-65-I-3 gm. 
30.-60. gm. 
I-90-3-75 gm. 




GLAUBER'S SALT (see Sodii 
Pr^eparata) 










GLYCYRRHIZA 

extractum glycyrrhizae .... 
extractum glycyrrhizae purum . 
glycyrrhizum ammoniatum . . 
mistura glycyrrhizae composita . 
pulvis glycyrrhizae composita (see 
Senna) 


578 

5791 

58o^ 

579J 
580 


ad libitum 
f gi-iv 


3-75-1 5.o gm. 




GOSSYPIUM 

extractum gossypii radicis fluidum 


275 

278 


f^ss-j 


I.90-3-75 gm- 




GRANATUM 

decocti granati (not official) . . 
pelletierine tannate (not official) 


605 
606 
605 


f^ij-iv 
gr. v-xv 


7.5-15.0 gm. 
0.32-1.0 gm. 




GRINDELIA 

extract of grindelia (not official) 
extractum grindeliae fluidum . . 


320 

321 
321 


gr. iij-x 


0.20-0.65 gm. 

0-6-375 gm. 




GUAIACOL (not official) .... 
carbonate (not official) .... 


518 
518 


TTLiij-v 

gr. vi-x 


0.18-0.3 gm. 
0.39-0.65 gm. 


TTlxv 

3J>2 


GUAIACUM 


382 

383 

} 383 


gr. x-xxx 

f 3 #-i 


0-65-1.95 gm. 
i-9°-3-75 gm. 




resina guaiaci 

tinctura guaiaci 

tinctura guaiaci ammoniata . . 




GUARANA 

extractum guaranae fluidum . . 
elixir guaranae (not official) . . 


141 
141 
141 


gi-ij 
TTlx-xx 

ad libitum 


3.9-7.80 gm. 
0.6-1.25 gm. 




H/EMATOXYLON 

extractum haematoxyli 

decoctum haematoxyli (not official) 


186 
186 


gr. x-xxx 

*3* 


0.65-I.95 gm. 
30.00 gm. 




HAMAMELIS . ... . . . . 

extractum hamamelidis fluidum . 


1S8 
189 


fgss-j 


I-90-3-75 gm- 




HEDEOMA 

oleum hedeomae 


233 


TTUJ- X 


0.10-0.55 gm. 





APPENDIX. 



625 



Page. 



HOMATROPINE HYDRO- 
BROMATE (not official) . . . 

HUMULUS 

extractum lupulini fluidum . . . 
infusion of hops (not official) 

lupulinum 

oleoresina lupulini 

tinctura humuli 

HYDRARGYRI PRiEPARATA 
chloridum corrosivum . . . . 
chloridum mite (calomel) . . . 



104 

"3 

114 
114 

114 

114 
114 

439 
454-502 

45° 



chloridum mite 374-45: 

606 



cyanidum . . . 
iodidum flavum 
iodidum rubrum 
oxidum rubrum 
subsulphas flavus 



456 
455 
455-503 
447 
456 



hydrargyrum cum creta .... 447 

hydrargyrum cum creta .... 447 

massa hydrargyri I 375-445 

massa hydrargyri 445 



Apothecaries' 
Measure. 



I Maximum 
Metric System, quantity in 
I 24 hours. 



HYDRASTIS 

extractum hydrastis fluidum 
hydrastinae hydro chloras . . . 
tinctura hydrastis 

HYOSCYAMUS (leaves and tops) 

extractum hyoscyami 

extractum hyoscyami fluidum 
hyoscinse hydrobromas .... 
hyoscine hydro chlorate (not of- 
ficial) 

hyoscyaminae hydrobromas . . 

hyoscyaminse sulphas 

tinctura hyoscyami 

ICTHYOL (not official) 

INGLUVIN (not official) .... 

INULA 

decoction (not official) .... 

IODOL (not official) 

IODOFORMUM 

IODUM 

compound tincture (not official) 
liquor iodi compositus (Lugol's) . 
tinctura iodi 



265 
267 
267 
268 

108 
108 
108 
109 

109 
109 
108 
108 

548 
166 

426 

545 

542 

461 
462 
461 



gr- 2I10- 



I % SS-1J 

f S ij-jv . 

gr. v-xij 
gr. ij-xxx 
fsji-iij 

g r - tVX (in 

syphilis) 
gr. v-x (as; 

purgative) 

g r - T6~X 

gr x-j 

g r - T6~X 

g^ tVX \ 

gr. lj-v (asj 

emetic) 
gr. v-x (as 

purgative) 
gr. %-] (in 

syphilis) 
gr. v-x (as 

purgative) 

g r - X~X ( in 

syphilis) 



f^X-J v 

g^ X 

gr. v-x 

gr- ij 
Hlx-xx 

gr- -shr-fa 



& 1 - TS 
gr. 3^0 
gr- T<b 
f.^X-i 
1T[iv-xx 

gr. v-xv 

fgMJ 

gr. ss-ij 

gr- j-iij 

I gr- X~X 

TTLXV— XXX 

my-* 

I TTLv-xx 



o.ooo? 
0.0006 g ra - 



1.90-7.50 gm. 
60-120 gm. 
0.32-0.78 gm. 

O.I3-I-95 g m - 
3.75-1 1.25 gm. 

0.001 1-0.004 gm. 

0.006-0.016 gm. 

0.32-0.65 gm. 
0.004-0.008 gm. 
0.016-0.07 gm. 
0.004-0.016 gm. 
0.004-0.008 gm. 

0.13-0.32 gm. 

0.32-0.65 gm. 

0.016-0.07 g m - 

0.32-0.65 gm. 

0.02-0.03 gm. 

0.9-15.0 gm. 
0.016 gm. 
o- 6 -3-75 g m - 
0.32-0.65 gm. 
0.13 gm. 
O.6-I.25 gm. 
0.0002-0.0022 gm 

0.00 1 gm. 
0.0002 gm. 
0.0006 gm. 
0.9-3.75 gm. 
0.24-1.25 gm. 
0.32-1.00 gm. 

30.0-60.0 gm. 

0.03-0.13 gm. 

0.07-0.20 gm. 

0.016-0.03 gm. 
0.9-1.90 gm. 
O.12-0.6 gm. 
0.3-1.25 gm. 



gr- iX 



gr- JX 



gr. 22 
gr. xv 

gr- tt 



f"3 v J 



gr. 8-15 
gr. 15 
gr. iij-v 



f3 

13 



40 



626 



APPENDIX. 



IPECACUANHA, 

as emetic . . 

as tonic .... 

emetine (not official), as emetic 




Apothecaries' 
Measure. 



Metric Svstem. 



as expectorant 



extractum ipecacuanhae fiuidum . 

extractum ipecacuanhae fiuidum, 
as emetic 

pulvis ipecacuanhae et opii (see 
opium) 

syrupus ipecacuanha;, as emetic . 

syrupus ipecacuanhae, as expec- 
torant 

tinctura ipecacuanhae et opii (see 
opium) 

vinum ipecacuanhae, as emetic . 

vinum ipecacuanhae, as expec- 
torant 



IRIS ......... 

extractum iridis . . . 
extractum iridis fiuidum 



JALAPA 

extractum jalapae . . . . , 
pulvis jalapae compositus . . 
resina jalapae 

JUGLANS 

extractum juglandis . . . . 

JUNIPERUS (not official) 

oleum juniperi 

spiritus juniperi 

spiritus juniperi compositus 



KAMALA (Rottlera) 

tinctura kamalae (not official^ 



KINO • . 

tinctura kino 

KRAMERIA 

extractum ki-ameriae . . . . 
extractum krameriae fiuidum . 

syrupus krameriae 

tinctura krameriae 

trochisci krameriae ... 

LACTUCARIUM 

syrupus lactucarii 

tinctura lactucarii . . 

LAPPA 

extractum lappae fiuidum . . 

LAVANDULA (not official) 

oleum lavandulae florum . . . 

spiritus lavandulae 

tinctura lavandulae composita . 

LEPTANDRA 

extractum leptandrae .... 
extractum leptandrae fiuidum . 
leptandrin (not official) . . . 



i 



327 
3 2 7 
327 
324 
327 



92 
327 



92 
327 



366 
367 
367 
362 
362 
362 
362 

355 
356 

398 

398 
398 

607 
607 

185 
185 

186 
186 
186 
186 
186 
186 

94 



386 

231 
231 

231 

359 
359 
359 
359 



gr. xv-xx 

g^- tV-X 

f^ss 
fgss 

f E S H 

f£SS 



gr. j-v 

gr. xv-xxx 
gr. i-v 
gr. x- 3 ss 
gr. iv-viij 



0.016-0.03 gm. 
1. 00-1.3 g m - 
0.006-0.012 gm 
0.006-0.016 gm 
0.3-1.90 gm. 

15.00 gm. 



20.00 gm. 
2.50 gm. 

15.00-30.00 gm 
1.90 gm. 

0.07-0.32 gm. 
1-25-3-75 g m - 
1. 00-I.95 g m - 
O.07-0.32 gm. 

0-65-I-95 gm. 
0.26-0.52 gm. 



gr. v-xxx J 0.32-1.95 gm. 



tUv-x 
f 3 i-ij 

f^i-iv 

gr. x-^ss 

gr. xx-xxx 
gr. x-xv 
f 5j ss-i 

i% i-iv 

1-4 
gr. x 
fgij-iv 
f&j-jss 

TTLxxx-xi 

gr. xx- 5 j 

gr. lj-iv 
f^ss-j 
gr. lj-jv 



0.28-0.55 g m - 
3.40-6.75 gm. 

3.9-7.80 gm. 
3.75-15.0 gm. 

0.65-1.95 gm. 
3-75-7-5 gm. 

1-3-1-95 gm- 

0.65-1.00 gm. 

I-9Q-3-75 gm. 
40.- 1 60. gm. 
3-75-7-50 gm. 

0.65 gm. 
10-20 gm. 
3.75-5.6 gm. 

1.90-7.5 gm. 

0.055-0.28 gm. 
1.70-2.25 gm. 
3-75 gm. 

1-3-3-9 gm. 

0.13-0.26 gm. 
1.90-3.75 gm. 
0.13-0.26 gm. 



Maximum 

quantity in 

24 hours. 



APPENDIX. 



627 



LIMONIS CORTEX 

oleum limonis 

spiritus limonis ..." 

LITHII PR^PARATA 

benzoas 

bromidum ...... 

carbonas „ 

citras 

citras effervescens . . . 
salicylas 

LOBELIA 

as antispasmodic .... 

as emetic 

extractum lobelise fluidum 
tinctura lobeliae .... 



Page. 



LUGOL'S SOLUTION (see 
Iodum) 

LUPULIN (see Humulus) 

MAGNESIA 

magnesii carbonas 

citras effervescens .... 
sulphas (Epsom salt) . . . 

MANGANI PR^PARATA . . 

mangani dioxidum 

mangani sulphas 

MANNA 

MALT EXTRACT (not official) . 

MARRUBIUM 

fluid extract of (not official) . . 

MASTICHE (see Aloes) .... 

MATICO 

extractum matico fluidum . . . 
tinctura matico 

MELISSA 

infusum melissae (not official) . 

MENISPERMUM 

extractum menispermi fluidum . 

MENTHA 

oleum menthae piperitse .... 

oleum menthas viridis 

spiritus menthae piperita? . . . 
spiritus menthae viridis . . . 

METHYL SALICYLAS (see 

Gaultheria) 

MEZEREUM 

extractum mezerei fluidum . . . 

MORPHINE SALTS (see Opium) 

MOSCHUS -i 

tinctura moschi j 



259 
259 
492 

493 
301 

492 

530 

3°4 
306 
306 
307 
3o7 



343- 493 

344, 494 

345 

344 

168 

169 

169,346 

333 
216 

233 
422 

4i5 

4i5 
415 
386 
387 

385 

231 

} 232 

233 

233 



Apothecaries' 
Measure. 



383 



142 



TtlJ-v 



gr. nj-v 
gr. x-xx 



gr. v-gi 



gr. 1-11] 
gr. v-xx 
TTLi-xxx 

iriv-fsi 



gr. xx- 31 
gr. x-gij 

zi-iv 

3 ss_ j 



gr. ij-v 
f^i-iv 

^ss-i 
f 3 ss-i 
f 3MJ 

ad libitum 
fsjss-j 



tllv-x 

trix-xx 
trLxxx-xi 



Hlx 



gr. x 

f5i 



Metric System. 



0.055-0.28 gm. 
375-7.5 g m - 

0.20-0.32 gm. 
0.65-I.3 gm. 

0.32-0.65 gm. 
o.32-3.9 gm. 



0.07-0.20 gm. 
0.32-1.3 gm. 
0.06-1.90 gm. 
0-3-3-75 g m - 



I-3-3-9 gm. 
0.65-7.80 gm. 

3-9-15-5 gm- 
1 5- 5-3'. I g m - 

0.07-0.65 gm. 
0.13-0:32 gm. 

3-9-93-3 g m - 
4.-20. gm. 

375-7.5 gm. 



1.95-3.9 gm- 

I.90-3.75 gm. 
3-75-7-5 gm. 



•90-3-75 g* 



0.28-0.55 gm. 

0.55-1. 12 gm. 

1.70-2.25 gm. 



Maximum 

quantity in 

24 hours. 



f^i-ij 



0.6 gm. 



0.65 gm. 
3-75 gm. 



628 



APPENDIX. 



MUSCARINE (not official) 

MYRISTICA 

oleum myristicse .... 
spiritus myristicae 

MYRRHA ....... 

tinctura myrrh se .... 

NAPHTHALINUM . . 



NAPHTOL 

NARCEINE and NARCO- 
TEINE (see Opium) 

NITROGLYCERINUM . . . . 

spiritus glonoini 

NUX VOMICA 

brucine (not official) 

extractum nucis vomicae .... 
extractum nucis vomicae fluidum 

strychninae sulphas 

strychnine sulphas (hypo.) . . . 
tinctura nucis vomicae . . . . 

OLEA 

oleum cajuputi 

betulae volatile 

cari 

erigerontis 

hedeomae 

morrhuae ....... 

pimentae 

ricini ...... 

(children) .... 

rosmarini 

santali 

sesami 

rutae (not official) . . 

thymi 

tiglii 



OPIUM 

acetum opii 

codeina . 

deodoratum 

extractum opii 

morphinae acetas, internally and 
hypodermically 

morphinae hydrochloras, inter- 
nally and hypodermically . 

morphinae sulphas, internally and 
hypodermically 

narceine (not official) 

narcoteine (not official) .... 

pilulae opii 

pulvis ipecacuanhae et opii 
(Dover's powder) . . . . 

pulvis morphinae compositus . . 

tinctura ipecacuanhae et opii . . 



Page. 


Apothecaries' 
Measure. 


no 


gr. A~J 




gr. x-xxx 


225 


Ulij-iij 




f^i-ij 


419 


gr. x-xxx 


419 


fgss-j 


534 


gr. ij-x 


535 


*gr. v-x 


3*4 


err 1 1 
S?' TOO 5 


314 


mi 


265 


gr. ij-iij 


261 


g r - 3V-T6 


265 


g r - l A-) 


265 


rry-v 


265 


gr- A-A 


265 


gr- A 


265 


triv^xx 


226 


TTLiij-vi 


230 


Hlv-x 


2 34 


mj-x 


395 


ITLv-xx 


233 


tilij-x 


468 


f^ss-f^i 


226 


TTLiij-vi 




fgss-j 
f^i-fgss 


337 


231 


(see com. tinct. 


414 


HXv-xx 


578 


as olive oil 


424 


rriij-v 


233 


mij-v 


374,56i 


mx-jK 


91 


gr. ss-ij 


92 


trixij 


93 


gr- ss-ij 


9i 


gr. ss-ij 


9i 


gr. ss 


1 




92 | 




«\ 


gr. ye-y 2 


92 J 




94 


gr- y 3 -H 


94 


gr- MJ 


9i 


gr- J 


92 


gr. x 


93 


gr. x 


92 


trtx-xx. 





Maximum 


Metric System. 


quantity in 




24 hours. 


O.OO22-O.07 g 111 - 




O.65-I.95 gm. 




0.10-0.16 gm. 




3.40-6.75 gm. 




0.65-1.95 gm. 




I-90-3-75 g m - 




0.13^.65 gm. 


gr. 60 


0.32-0.65 gm. 


SJ 


0.0006-0.0013 gm. 




0.06 gm. 




0.13-0.20 gm. 


gr. iv 


0.0022-0.004 gm. 




0.3-0.07 gm. 




, 0.06-0.3 gm. 


Tftx-xv 


0.002-0.004 gm. 


gr- K 


o.oon gm. 




0.3-1.25 gm. 


f^ss-j 


j 0.16-0.32 gm. 




| 0.28-0.55 gm. 




i °. °55-o. 5 5 g m - 




0.28-1. 1 2 gm. 




0.10-0.55 gm. 




! 1.70-27.0 gm. 




! 0.16-0.32 gm. 




13.50-27.00 gm. 




3.40-13.50 gm. 




lavender) 




O.28-1. 1 2 gm. 




0.10-0.28 gm. 




0.10-0.28 gm. 




0.016-0.09 gm. 


nrtiij 


0.03-0.13 gm. 


gr- 1% 


0.72 gm. 




0.03-0.13 gm. 


gr. vi 


0.03-0.13 gm. 




0.03 gm. 


gr. v 


0.010-0.03 gm. 


gr. jss 


0.02-0.05 gm. 




0.20 gm. 




0.07 gm. 




0.65 gm. 


3J-§ r - x 


0.65 gm. 




• 0.6-I.25 gm. 





APPENDIX. 



629 



OPIUM — Continued 

tinctura opii camphorata (pare- 
goric) 

tinctura opii deodorati . . . . 

tinctura opii (laudanum) . . . 

trochisci glycyrrhiza? et opii . . 

trochisci morphinae et ipecac- 
uanhae 

vinum opii 

PANCREATINUM 

PAPAYA (not official) 

PARALDEHYDUM 



PAREIRA 

extractum pareirae fluidum . . . 

PELLETIERINE (see Gra- 

NATUM) 

PEPO 

extractum peponis fluidum (not 
official) 

PEPPERMINT (see Mentha) 

PEPSINUM •) 

saccharatum / 

PHENACETINE (not official) . 

PHENOCOLL HYDROCHLO- 
RIDE 

PHOSPHORUS 

elixir phosphori 

oleum phosphoratum 

pilulae phosphori 

spiritus phosphori 

PHYSOSTIGMA 

eserine (not official) ..... 



extractum physostigmatis . 
physostigminae salicylas or sulphas 
tinctura physostigmatis .... 

PHYTOLACCA 

extractum phytolaccae fluidum . 
tinctura phytolaccae (not official) 

PICROTOXINUM 

PILOCARPUS 

extractum pilocarpi fluidum . . 
pilocarpine hydrochloras . . . 
pilocarpinae hydrochloras (hypo.) 

PIPER 

oleoresina piperis 

piperinum 



PIX LIQUIDA (tar) . 
oleum picis liquids . 
syrupus picis liquidae 



Page. 


Apothecaries' 
Measure. 


Metric System. 


Maximum 

quantity in 

24 hours. 


92 
92 
.92 

91 


Vgss 

m*ij 
1-4 


15.0 gm. 
O.72 gm. 
0.72 gm. 




93 
92 


1-2 

TTlv-xx 


0.3-I.25 gm. 




167 


gr. v-x 


0.32-0.65 gm. 




168 


gr. i-v 


0.07-0.32 gm. 




96 


f^ss-j 


I-9Q-3-75 gm- 


f 5iJX 


415 
415 


f 3 s H 


T -95"3-9 g m - 
1 -90-3-7 5 g m - 




605 








608 


ii-ij 


31. 0-62.0 gm. 




608 


f ^ s H 


15.0-30.0 gm. 




166 


gr. v-xx 


0.32-I.3 g m - 




539 


gr. v-xv 


O.32-I.0 gm. 


3*X 


539 


gr. viij-xv 


0.52-1.0 gm. 


&% 


179 
179 
179 

179 
'179 


triv-xx 
1-3 

tltv-xxx 


0.0022 gm. 

3-75 gm- 
o-3- I - 2 5 g m - 

0.28-1 70 gm. 


g r - TO 


292 
292 
292 
292 
292 


gr. ij-v 

gr. A-A 

g^ yi-'A 

gr. *W 
ITLv-xv 


0.13-0.32 gm. 
0.00 1 1-0.005 g m - 
0.00S-0.016 gm. 
0.001— 0.010 gm. 
0.3-0.9 gm. 


g r - T2 

g^ X 


248 
248 

248 


gr. i-xxx 

Tflx-xx 


0.07-1.95 gm. 

0-3-3-75 g m - 
0.6-1.25 gm. 




269 


err 1 1 
g r - 6 0~-2-0 


0.001 1-0.0032 gm. 


gr- % 


378 
380 
380 
380 


f5 SS -J 

g r - l /s~ l X 

gr- tV-X 


i-9°-3-75 g m - 
0.008-0.016 gm. 
0.006-0.016 gm. 


gr- j 


223 


gr. v-x 
gr. ss-ij 
gr. ij-x 


0.32-O.6.5 gm. 
0.03-0.13 gm. 
0.13-0.65 gm. 


gr. 18 


409 
410 
409 


Tflx-xv 


0.55-0.80 gm. 
5.0-10.0 gm. 





630 



APPENDIX. 



PLUMBI PRiEPARATA 

acetas 

iodidum 

nitras 



PODOPHYLLUM 

extractum podophylli .... 
extractum podophylli fluidum 
resina podophylli 

POTASSII PRiEPARATA . 

potassa sulphurata 

acetas . . . . 

bicarbonas 

bichromas 

bitartras 

bromidum 

carbonas 

chloras 

citras 

citras effervescens 

cyanidum 

hypophosphis 




iodidum 



liquor potassge 

liquor potassii citratis 

nitras 

nitris (not official) 

permanganas 

et sodii tartras ( Rochelle salt) . 

sulphas 

PRUNUM (see Confectio Senn^;) 

PRUNUS VIRGINIANS 

extractum pruni virginianse fluidum 
infusum pruni virginianae . . . 
syrupus pruni virginianae .... 

PULSATILLA . . 

tinctura pulsatillae (not official) . 

PULVIS AROMATICUS . . . 

PYRETHRUM 

tinctura pyrethri 

QUASSIA '. . 

extractum quassiae 

extractum quassiae fluidum . . . 
tinctura quassiae 

QUERCUS ALBA 

decoctum querci albi (not 
ficial) 



QUILLAJA . . . 

tinctura quillajae 



of- 



QUININE 

chona) 



SALTS (see Cin- 



228 



Apothecaries' 
Measure. 



Maximum 
Metric System, quantity in 
I 24 hours. 



gr. l-iv 
gr. ii-iv 

gr. X-j 



gr. xv- 3 J 



gr. 11-v 
Ttlxv-xlv 

gr. x-xxx 



423 i TTlx-xx 



gr. x-31 

gr. v-x 



f^ij 



403 gr. x-xx 
403 f 3 M-iJ 



0.07-0.26 gm. 
o. 13-0.26 gm. 
0.016-0.07 g m - 

0.65-1.3 gm. 
0.32-1.00 gm. 
0.6-1.25 g m ' 
0.016-0.07 gm. 



0.13-0.65 gm. 

1-3-3-9 g m - 
0.65-1.3 gm. 
0.005-0.010 gm. 

1 -95-3-9 g m - 
-65-3-9 gm. 
0.65-1.3 gm. 

o-3 2 ~ I -95 S m - 
I -3- I -95 g m - 

5-9 g m - 
0.008 gm. 

0-65-1.95 gm. 
0.32-1.0 gm. 

0.6-1.25 gm. 
15.0 gm. 
0.65-1.95 gm. 
0.20-0.32 gm. 
0.07-0.13 gm. 
15. 5-31. 1 gm. 
1.0-3.9 gm. 



3-75-7-5 g m - 
60.0 gm. 
20.0 gm. 

0.13-0.32 gm. 
0.9-3.0 gm. 

0.65-1.95 gm- 

0.6-1.25 gm. 

0.65-3.9 gm. 
0.32-0.65 gm. 
0.3-0.6 gm. 
3.75-7.5 gm. 



60.00 gm. 

0.65-1.95 gm. 
I.90-7.5 gm. 



gr. 8 



APPENDIX. 



631 



Pa ff e. 



RESORCINUM . . . . T . . . 

RHAMNUS PURSHIANA (Cas- 

cara Sagrada) 

extractum rhamni purshianae 

fluidum 

elixir cascara sagrada, aromatic 

(not official) 

elixir cascara sagrada, tasteless 

(not official) 

extract of cascara sagrada (not 

official) 

RHUBARB 

extractum rhei 

extractum rhei fluidum .... 

mistura rhei et sodae 

pilulaa rhei 

pilulae rhei compositae 

pulvis rhei compositus 

syrupus rhei 

syrupus rhei compositus .... 

tinctura rhei 

tinctura rhei aromatica .... 

tinctura rhei dulcis 

tinctura rhei et sennae (not official) 

RHUS GLABRA 

extractum rhois fluidum . . . . ; 

RHUS TOXICODENDRON . 

ROCHELLE SALT (see Potassii 
Pr^eparata) 

ROS^ PR^PARATA 

extractum rosae fluidum .... 

oleum rosae fluidum 

syrupus rosae i 

ROTTLERA (see Kamala) 

RUBUS 

extractum rubi fluidum . . . . ; 
syrupus rubi 

RUBUS IDiEUS 

extractum rubi idaei 

syrupus rubi idaei 

RUMEX 

extractum rumicis fluidum . . 



SABINA . . . 

oleum sabinae 



SALIPYRINE (see Antipyrine) 

SALIX (not official) 

salicinum 



SALOL 

SALOPHEN (not official) 



189 
190 



190 
190 

190 
190 



424 
424 



164 

164 

532 
534 



Apothecaries' 
Measure. 



gr. iij-viij 



Maximum 
Metric System, quantity in 
24 hours. 






fgss-j 



190 I fgi-ij 
268 gr. i-iij 



0.20-0.52 gm. gr. 45 



O.65-I.95 gm. 



3-75 gm- 



gr. v-x 


0.32-0.65 gm. 


g r - x -3 { 


°-65-3-9 gm. 


gr. x-xxx 


0.65-1.95 gm. 


Hlx-f^ss 


0.6-1.90 gm. 


fgi-jv 


30.0-120.0 gm 


i-3 




2-5 




3SS-1 


T -95-3-9gm. 


f^i-f^i 


5.0-40.0 gm. 



15.0-30.0 gm. 



3.75-7.5 gm. 
O.07-O.20 gm. 



as perfume 
as vehicle 


3-75-7-5 gm. 




fgss 


3-75-7-5 gm. 
20.0 gm. 




f^ss-j 


3-75-7-5 gm. 
20.0-40.0 gm. 




*3J 


3-75 g m - 




gr. v-x 
1Uv-x 


0.32-0.65 gm. 
0.28-O.55 gm. 




gr. x-xx 
gr. iij-xv 


0.65-1.3 gm. 
0.20-1.00 gm. 


3 1 ! 


g r - v ~3i 


0-32-3-9 gm- 


z i i 


gr. xv-xx 


1. 0-1.3 gm. 





632 



APPENDIX. 






SAMBUCUS 

decoction (not official) . . . . 

SANGUINARIA, as emetic . . . 

extractum sanguinariae fluidum, 
as emetic 

tinctura sanguinariae, as emetic . 

tinctura sanguinariae, as expec- 
torant 



SANTONICA . . . 

santoninum . . . 
trochisci santonini 



SARSAPARILLA 

decoctum sarsaparillae composi- 
tum 

extractum sarsaparillae fluidum . 

extractum sarsaparillae fluidum 
compositum 

syrupus sarsaparillae compositus i 

SASSAFRAS 

mucilago sassafras medullae 
oleum sassafras . . . 



SCAMMONIUM . 

resina scammonii 



SCILLA 

acetum scillae 

extractum scillae fluidum 

syrupus scillae 

syrupus scillae compositus 
tinctura scillae 



SCOPARIUS 

extractum scoparii fluidum 
infusion (not official) . . 

SCUTELLARIA 

extractum Scutellariae fluidum 
infusum Scutellariae (not official) 

SENEGA 

extractum senegae fluidum . . 
syrupus senegae 

SENNA 

confectio sennae 

extractum sennae fluidum • . 
infusum sennae compositum . 
pulvis glycyrrhizae compositus 
syrupus sennae 

SERPENTARIA 

extractum serpentariae fluidum 
infusum serpentariae (not official) 
tinctura serpentariae . 

SINAPIS 



Anotheraries' Maximum 

Ap R °i^f,t" eS Metric System, quantity in 



Measure. 




24 hours. 



0.65-1 3 g m - 

Q-9-3-75 gm. 
11. 25-15.0 gm. 

0.3-1.90 gm. 

0.65-1.95 gm. 
0.03-0.32 gm. 



120.0-iao.o gro^ 
1 -90-3-75 gm. 

i-9°-3-75 gm. 
5.C-20.0 gm. 



gr- lYz 



577 
386 

3 6 9 

3 6 9 

39 1 
39 1 
39i 
39i 
39i 
39i 



ad libitum 

my-* 

gr v-x 
I gr. jv-viij 

gr. j. repeated 

m^-fo-ij 1 

TIIHJ 

Hlv-f3i 
Hlv-xxx 



399 f 3 ss " 

399 M\ 



133 



rriv-xx 



0.10-0.55 gm. 

0.32-0.65 gm. 
0.26-0.52 gm. 

o 07 gm. 

0.9-7-5 gm. 
0.06-0.12 gm. 
5.00 gm. 
0.40-5.00 gm. 

0.3-1-9° g m - 



1 -9°-3-75 gm. 
30 00 gm. 



0.3-1 25 gm. 

^O.O 2TH. 



402 


gr. x-xx 


0-65-1.3 gm. 


402 


TUx-xx 


0.6-1.25 gm. 


402 


f^ 1 - 1 ! 


5.O-I0.0 gm. 


359 


Z ss -iJ 


I.95-7.80 gm. 


359 


sj-y 


3.9-7.3o gm. 


359 


U 1_jv 


3-75-15-° g m - 


359 


fjss-j 


15.0-30.0 gm. 


359-58o 


f.^i-ij 


3.9-7.80 gm. 


359 


f^i-ij 


5.00-IO.0 gm. 


148 






149 


fgss-i 


I-90-3-75 gm. 


149 


fji-ij 


30.0-60.0 gm. 


149 


f 3 l ~ l i 


3-75-7-5 gm- 


553 


3 i-iv as 






emetic 


3-9- I 5-5 gm. 



SODII PRiEPARATA .... 

acetas 

benzoas 

bicarbonas 

boras 

bromidum 

carbonas 

carbonas exsiccatus 

chloras 

hypophospbis ........ 

iodidum 

liquor sodae 

nitras 

nitris (not official) 

phosphas (as cathartic) .... 
hypophosphas (as cathartic) . . 

salicylas 

sulphas (Glauber's salt) .... 

sulphis 

bisulphis 

hyposulphis 

sulphocarbolas 

trochisci sodii bicarbonatis . . 

SPARTEINE SULPHAS . . 

SPIGELIA 

extractum spigeliae fluidum . . . 
worm tea (not official) .... 

STAPHISAGRIA 

extractum staphisagriae fluidum 

(not official) 

tinctura staphisagriae (not official) 

STILLINGIA 

extractum stillingiae fluidum . . 
tinctura stillingiae (not official) . 

STRAMONIUM (leaves and seeds) 

daturine (not official) 

extractum stramonii fluidum 
seminis ..... ... 

extractum stramonii seminis . . 
tinctura stramonii seminis . . . 

STRONTII PRiEPARATA 

bromidum 

iodidum 

lactas 

STROPHANTHUS 

strophanthin (not official) . . . 
tinctura strophanthi 

STRYCHNINE (see Nux Vomica) 

STYRAX 

SULPHUR LOTUM 



APPENDIX. 




633 


Page. 


Apothecaries' 
Measure. 


Metric System. 


Maximum 

quantity in 

24 hours. 


487 








388 


gr. xx- 3 1 


1. 3-I.95 gm. 




525 


gr. v-xx 


0-3 2 -I.3 gm. 




489 


1 






508 
301 


gr. x-xxx \ 


O.65-I.95 gm. 




488 


1 






488 


gr. v-xv 


0.32-1.00 gm. 




482 


gr. v-xx 


0-32-1.3 gm. 




479 


gr. x-xxx 
gr. v-xv or 


O.65-I.95 gm. 




465 


more 


O.32-1.00 gm. 




487 


TTtx-xx 


0.6-1.25 g m - 




255 


gr. x— xxx 


0.65-I.95 gm. 




315 


gr. lij-v 


0.20-0.32 gm. 




347 
347 


% ss-iv 1 
3 ss-iv J 


I -95- I 5-5 gm. 




53° 


gr. v-31 


0.32-3.9 gm. 




346 


gss-i 


IS-5-3I-I gm. 




504 


gr. v-xx 


O.32-I.3 gm. 




504 


gr. v-x 


0.32-0.65 gm. 




5°4 


gr. x-xxx 


0.65-1.95 g m - 




5i6 


gr. x-xv 


0.65-1.00 gm. 




489 


1-3 






285 


g r - %-% 


0.008-0.016 gm. 


g r - JX 


601 


gr- x-^ij 


0.65-7.80 gm. 




601 


f.^i-ij 


3.75-7.50 gm. 




601 


fgi-iv 


30.0-120.0 gm. 


* 


249 


gr. i-iij 


0.07-0.20 gm. 




249 


ttU-v 


0.07-0.3 gm. 




249 


rru-xv 


0.6-0.9 gm. 




386 


gr. xv-xxx 


1-2 gm. 




386 


fs# 


1.90 gm. 




386 


fgss-i 


1 9°-3-75 g m - 


[leaves] 


106 


gr- 1J 


0.13 gm. 


gr. xv of 


105 


g r - tIWo 


0.0005-0.0032 gm. 


g r - to 


106 


mij-v 


0.12-0.3 g m - 




106 


gr. ^ 


0.03 gm. 


gr. 8-10 


106 


TT^v-xxx 


0.3-I.90 gm. 




301 


gr. x-xxx 


0.65-1.95 gm. 




465 


gr. v-xv or 
more 


0.32-1.00 gm. 




176 


gr. x- 5 ss 


0.65-1.95 gm. 




283 


ft 1 " To"o ^"0 


0.0006-0.001 1 gm. 




283 


w-^ 


0.06-1.25 gm. 


fff* 


421 


gr. x-xx 


0.65-1.3 gm. 




339 


gi-ij 


3.9-7.80 gm. 





6B4 



APPENDIX. 



SUMBUL 

tinctura sumbul 

SULPHONAL (not official) . . 

SYRUPI 

syrupus acidi citrici 

acidi hydriodici 

hypophosphitum .... 
hypophosphitum cum ferro . 

TAMARINDUS (See Confectio 
Senn^e) 

TANACETUM 

oil of tansy (not official) . . . 

TARAXACUM 

extractum taraxaci 

extractum taraxaci fiuidum . . . 



TEREBENUM . . 

TEREBINTHINA 

as blennorrhetic . 
as anthelmintic . 



Page. 



321 

322 

97 



Apothecaries' 
Measure. 



gr. xv-xxx 



oleum terebinthinge 

oleum terebinthinge retificatum . 

oleum terebinthinge, as blennor- 
rhetic . . . . • . . . . 

oleum terebinthinge, as anthel- 
mintic 



TERPINI HYDRAS . . . . 

THYMOL 

TRAGACANTHA 

mucilago tragacanthge . . . . 

TRITICUM 

decoction (not official) . . . 
extractum tritici fluidum . . . 

ULMUS 

mucilago ulmi 

UVA URSI . . 

arbutin (not official) .... 

extractum uvge ursi 

extractum uvae ursi fluidum . 

VALERIANA 

ammonii valerianas 

extractum Valerianae flui lin . 

tinctura valeriange 

tinctura valeriange ammoniata 

VANILLA 

tinctura vanillge 



259 i"3 i-iJ 

466 J f^i-ij 

479 f5HJ 

479 f^i-ij 



332 

426 
426 

396 
397 
397 
408 

404 

406 

406 

\ 4o6-7, 

/ 606 

406-7 



gr. x-xxx 



gr. xx- 5 j 

TTtv-x 



gr. xx- 3 i 
.1 ss- i 



Tttv-xxx 

408 \ gr. i-v 
546 gr. i-x 



574 

397 
398 
398 

576 

577 

4i7 
4i7 
4i7 
4i7 

i3 2 
132 
132 
132 
132 



234 



VEGETABLE CATHARTIC 
PILLS (see Colocynth) 

VERATRINA (rarely used) . . . | 



as a vehicle 

ad libitum 
f^ss-j 

as a vehicle 

gr-x-gi 
3X-J 

gr. x-xx 

^ss-jss 
gr. ij-viij 

f^HJ 

fgss-j 



Metric System. 



0.6-375 g m - 
1—2 gm. 



5.0-10.0 gm. 
5^0-10.0 gm. 
5.0-io.ogm. 
5.0-10.0 gm. 



0.65-1.95 gm. 
0.055-0.10 gm. 

1-3-3 9 gm. 
3-75-7-5 gm. 
0.28-0.55 gm. 



1-3-3-9 g m - 
I5-5-3I-0 gm. 



0.28-1.70 gm. 

6.75-13.50 gm. 
0.07-0.32 gm. 
0.07-0.65 gm. 



I.90-3-75 gm- 



0.65-3.9 gm- 
1.00-3.9 gm. 
0.65-1.3 gm. 
I.90-3-7.5 g m - 

1-95-5-9 gm- 
0.13-0.52 gm. 

3-75-7-5 gm- 
1 90-3-75 gm. 
3.75-7.5 gm. 

3.75-7.50 gm. 



Maximum 

quantity in 

24 hours. 



31SS-31J 



245 I g^ xV-i 



0.005-0.010 gm. gr. y 



APPENDIX. 



635 



Page. 



Apothecaries' 
Measure. 



Maximum 
Metric System, 'quantity in 
24 hours. 



VERATRUM VIRIDE . . . . j 

extractum veratri viridis fluidum 
tinctura veratri viridis 

VIBURNUM 

extractum viburni opuli fluidum . j 
extractum viburni prunifolii do . 

WOORARA (not official) 

curarine (not official) 

XANTHOXYLUM 

extractum xanthoxyli fluidum . j 

ZEA 

fluid extract (not official) . 
infusion (not official) . . 

ZINCI PRiEPARATA . . 

bromidum 

phosphidum 

sulphas 

valerianas 



ZINGIBER 

extractum zingiberis fluidum 
oleoresina zingiberis . . . 
syrupus zingiberis .... 
tinctura zingiberis .... 
trochisci zingiberis .... 



244 
244 
244 



320 
3*9 

3i8 
318 

385 
385 



399 

198 
301 
179 
199 
201 

227 

227 
227 
227 
227 
227 



gr. i-i] 
HI iv-vj 

f 3 s M 

g r - TO"! 

g r - ?fo 



gr. x- 

f^ss 



0.07-0.13 gm. 
I 0.24-0.36 gm. 



ro"o" 
3 SS 



f 'Z ss-j 



ij-xx 

j- v 
i-ij 



g r - 

g r - 

g r - 

g r - 

gr. i-xx 

Tlflxx-xxx 

gr- HJ 
ad libitum 
f 5 ss-j 
ad libitum 



0.3-0.6 gm. 

3-75-7-5 gm. 
i-9°-3-75 gm. 
0.006-0.012 gm, 
o.ooo3-o.ooo6gm. 

0.65-1.95 gm. 
1.90 gm. 



I-90-3-75 gm. 
60.00 gm. 



o.^" 1 ^ gm- 
0.0032-0.016 gm 
0.07-0.32 gm. 
0.07-0.13 gm. 

°- 6 5- I -3 g m - 
1.25-1.90 gm. 
0.07-0.13 gm. 

i-9°-3-75 gm. 



large doses 
cause vo- 
miting. 



IV. SOLUTIONS FOR HYPODERMIC USE. 



ANTIPYRINE: 

R Antipyrine, gr.v ; 

Aquae destillatae, q. s. to dissolve. 

M.S. — Inject; as a rule it causes 

some pain at seat of injection. 

APOMORPHIA: 

R Apomorphinae hydrochloratis, gr. 

Aquae destillatae, f^i. 
M.S.— fllx contain gr. ^ ? . It 
may be obtained in the form of 
hypodermic tablet, gr. ^V— to- 
ARSENIC: 

Liquor potassii arsenitis, YTL V_XV 
may be injected, but the com- 
pound tincture of lavender 
should be omitted from this 
solution, as it makes the injec- 
tion irritating. 
ATROPINE SULPHAS: 

Dissolve gr. i in fgi of distilled 
water; Ttti contains gr. -fa. 
Can be had in hypodermic 



tablets, gr 



Chil- 



dren are not so susceptible to 
its influence, in proportion to 
age, as adults. The aqueous 
solution should be freshly made 
to prevent formation of a peni- 
cillium which grows at expense 
of alkaloid. 
CARBOLIC ACID: 

R Acidi carbolici (purified), gr.v ; 
Aquae, f^ss. 

M.S. — Ten minims contain gr. A. 
Makes an irritating injection. 
COCAINE: 

Maybe given in three ways : 
(i) R Cocainae hydrochloratis, gr.iij ; 
Aquae destillatae, f^ss. 
M. S. — Ten minims contain gr.^. 

(2) R Cocainae hydrochloratis, gr. i ; 

Olei vaselini, f^iss. 

M.S. — Fifteen minims contain 

g r - h 

(3) R Hypodermic tablets, gr. T V, i, |. 

Cocaine -solutions by standing de- 
teriorate in strength. 

636 



CREOSOTUM (Beechwood or guaia- 
col): 
R Guaiacol, ft^i-ii; 
Aquae, TTL XX - 

M.S. ^-Inject TT1 i-x. Vaseline 
oil may be used as solvent. Is 
stated to be almost non-irritant. 

CURARINE: 

Grain one in Til 150 °f distilled 

water, of which solution 1TLJ 

may be injected; or hypodermic 

tablet, gr. Y^j maybe employed. 

DIGITALIN: 

R Digitalin (German), gr. ij ; 
Aquae destillatae, f^ss. m 
* M.S. — Two minims contain 

gr.^L. It may be had in hy- 
podermic tablet, gr. yi^. 

ERGOTIN: 

One drachm to distilled water, 
f ^ ss, makes a solution of which 
YTL i contains gr. %. The in- 
jection is followed by pain and 
tumefaction. 
ESERINE: 

R Eserinae hydrochloratis, gr. iv ; 
Aquae destillatae, f % i. 
M.S. — TT[i contains gr. t |q-. Hy- 
podermic tablets, gr. y^-— T jq 
are obtainable. 
FERRUM DIALYSATUM: 

'ftlxv; or a one per cent, solu- 
tion of ferric citrate in water, 
may be injected. 
HYOSCINE AND HYOSCYA- 
MINE: 
R Hyoscinae hydrobromatis or hy- 
drochloratis, gr. i ; 
Aquae destillatae, f^i. 
M.S. — Minims two contain gr. 
1 

R Hyoscyaminae hydrobromatis or 
hydrochloratis, gr. j ; 

Aquae destillatae, fji. 

M.S. — Minims two contain gr. 
^ip-. They may be used in 
form of hypodermic tablet. 



APPENDIX. 



637 



IODINE: 

Tinctura iodi, TTLii _v * s injected, 
dissolved in a little water to 
which has been added potas- 
sium iodide, gr.ij-iij, for the 
purpose of effecting solution. 
Either potassium or sodium 
iodide, gr. v-xv, may be inject- 
ed, dissolved in water. Pain 
and burning with a lump about 
seat of injection usually follow ; 
frequently iodism ensues. 
IODOFORM: 

May be dissolved in olive or 
eucalyptus oil; the doseisgr.i-iij. 
MERCURY: 

Hydrargyri et sodii iodidi, gr. viij ; 
Aquae destillatse, f^i. 
M S. — TTL8 contain gr.i 
Hydrargyri chloridi corrosivi, 

gr.j; 

Aquae destillatse 
M.S.— Dissolve 



»R 



(2)B 



f^i. 

by heat; Tltx 
These injections 



contain gr.^g. 
are irritating. 

\ Acetas, 
MORPHINE : \ Hydrochloras, 

J Sulphas. 
Of either salt, gx.ye, %, %, dis- 
solved in TTL XV-XX of distilled 
water ; now usually made into 
solution from compressed hy- 
podermic tablets, gr. -^ to j^, 
and often put up with atropine, 
gr. T -L. The hypodermic dose 
of morphine for children is 
g r - sWoj according to age. 



Unless the solution is made as 
wanted, a penicillium grows at 
expense of alkaloid. 
PILOCARPINE HYDROCH- 
LORAS : 
Of this salt, gr.i in water, f^ss, 
10 minims contain gr.^; or it 
may be had in hypodermic 
tablets, gr. yq-%. The solu- 
tion requires to be freshly 
made, and cautiously used. 
STRYCHNINE SULPHAS: 

Ten minims of gr. i in distilled 
It 



water, f 5ji, contain gr. 



4~- 



may be had in hypodermic 
tablet, gr. T ^. The seat of in- 
jection is marked by heat, red- 
ness and pain. 
QUININE r 

Dr. Lente's formula is : 
R Quininae disulphatis, gr.50; 

Acid, sulphuric!, dil. TTLioo; 

Aquae font., f ^i; 

Acid, carbolici, liq., tTL5. Solve. 

" Place the quinine and water in 
a porcelain dish over a spirit 
lamp ; heat to the boiling point 
and add the sulphuric acid, 
stirring with a wooden spatula. 
Filter at once and add the car- 
bolic acid." Minims 10 con- 
tain gr. i. 

The subcutaneous injection of 
quinine solution produces a 
burning and redness about the 
puncture, and diffuse inflamma- 
tion and suppuration may ensue. 



V. STRENGTH OF ALCOHOLIC LIQUORS. 



Alcoholic (sp. gr. 0.825) strength by 
measure of wines, beers and liquors : 

Per Cent. 

Ale (Burton) 8.88 

Ale (Scotch) 6.20 

Beer (Lager) 3.00 

Brandy 53.39 

Brown Stout 6. 80 

Burgundy 12 to 16.60 

Champagne (sparkling) 12.80 

Cider 7.50 

Claret 14 to 17.00 

Elder Wine 9.87 

Gin 51.60 



Per Cent. 

Hock I 3-S° 

Johannisberger 8.71 

Madeira 19.24 to 24.42 

Mead 7.32 

Orange Wine 11.28 

Port 21.40 to 23.48 

Porter, London 4.20 

Rhenish Wine 8.7 1 

Rum 53.68 

Sauterne 14.22 

Sherry 18.25 to 19.83 

Tokay 9.88 

Whiskey, Irish 53-90 

Whiskey, Scotch 54-3 2 



CO 

W 
H 

t-H 

CO 

< 

< 

O 

W 

< 



Z 
< 

H 


Isolation ; epila- 
tion ; wash scalp 
with soap ; sul- 
phurous acid fspj 
to water f Sji; cor- 
rosive sublimate gr. 
i-ii to ^i; dilute 
sol. acid nitrate of 
mercury. 


Do. Also chry- 
sarobin . 


.2 

p 

& 

> 


Mode of Trans- 
mission. 


From fungi floating 
in air which settle 
upon skin, its fis- 
sures and hair-roots; 
can be transmitted 
from man to man. 


Do. 

Can be transmitted 
from one person to 
another. 


Do. 


% 

o 

H 


One or more spots 
or patches, ^ to 4 
in. in diameter; hairs 
brittle ; contain fun- 
gus ; much itching, 
often baldness. 


Grows fr. vesicle, ex- 
tending in erythe- 
matous circle ( y 2 
in. ) on red base, the 
centre healthy look- 
ing ; secretion of 
vesicles forms scales. 
Parasite burrows 
centrifugally ; much 
itching. 


Itching, then red 
papules becoming 
pustular, each pus- 
tule perforated by a 
hair; skin purplish; 
yellowish brown 
crusts form ; hairs 
are matted together. 


Z 

< 

H 

OQ 


Hairs above follicle, 
and superficial cells 
of epidermal scalp; 
frequent in children. 


Neck, face, back, 
and extremities. 


Hairy parts of face 
and neck. 


H 

< 

Ph 


Tricophyton tonsurans. 
Occurs as mycelial 
tubes, jointed or bro- 
ken, or in chains of 
sporules. 


Tricophyton circina- 
lum ; minute spores 
and mycelia. 


Microsporon menta- 
grophytes. 


Z 
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s 
a 

o 
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% 



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M-3 



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Scu 



(U o 



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S- 2 = 



li^.r.rg-is|i-s 

~ g 53 g <■> g «op 

^|-S g^ tag, .-I" 

tn ,_ .G "- 43 ^ 3 •« w en . 

OS o ^ £ 44 .„ 03 — ' 

« 8 *r «f ^ ,, 12 H - 

w-s « w © gr-G -c s 

PQ > ^S oS .5 -S tn ? O 42 G 



<U t3 

CD C 



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S o a $ a 

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g oS Q. cu 2 
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If numerous, hair should be cut short; 
wash of corrosive sublimate, gr.i to aq. 
f^i; or turpentine oil; or carbolic acid 
I to 50. 


Ditto. 


Chloroform evaporated near parasite de- 
stroys it ; or phytolacca or mercurial 
ointment ; corrosive sublimate solution. 


Fumigating clothing with sulphur. Wash 
parts with soap and warm water; then 
apply sulphur or naphtol ointment. 


z* 

o 

o 

u> 

P 

o 
Ph" 

Ph 

Ph 

p 

< 

z 
o 

H 

& 

2 
o 

a 

Q 


Length, male -fa in., female, T ^; color, 
light gray with black margin ; wingless ; 
6 lateral appendages, uniformly attached 
to the thorax ; body in segments ; mouth 
suctorial; ovoviviparous, no metamorpho- 
sis; the young differing simply in size; 
ova are attached to hairs as white specks 
or nits. 


Much larger than p. capitis; inhabits 
clothing, and lives by sucking blood, 
which causes tiny haemorrhagic specks; 
much itching ; multiplies rapidly. 


Resembles the other pediculi. Grasps 
hairs with great tenacity ; at their roots 
are small red spots ; hairs are glued toge- 
ther by secretion of insect ; itching severe. 


A microscopic, tortoise- like, almost trans- 
parent parasite, inhabiting a burrow in 
epidermis; has a head, mandibles, 8 legs, 
each anterior having a terminal sucker. 
Female lays eggs in deep epidermis. 
Lesions vary with irritation caused by 
scratching, from vesicles to pustules. 


z' 

o 

H 

«! 
£> 

H 




tub 

_c 



C 
03 

?-. 




Pubic region ; infre- 
quently axillae. 


Web between toes and 
fingers; back of hands, 
axillae ; abdomen. 


< 

p< 

o 

W 

Ph 
C/2 


"a? 
3 

.si 

B.-Q 

o3 "~^ 


0) 
en 

3 
JO 

•r >^ 

II 

a 


3. Pubis 

(crab-louse). 


Acarus or Sarcoptes 
Scabiei (itch-mite). 


C/3 

to 

<; 
1-1 
U 


Pediculus (annulosa, 


"o? 
'o 

1 

<l> 

-s 

oj 
<«> 

a 




Acari, or Mites (an- 
nulosa, arachnida, 
family, acarida). 



u 






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cu to 

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s-, "> "* a; 
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2 ^2 2 « o 






fl C - CL, o ^ 

OJ <U 2 ft V £ 

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-s a £-& ~ § « 

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pq 2 S •£ aJs\S 



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cu-5 



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p, p, o 



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CO 


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ulos 

a, 

licic 


h4 

u 


Bed-bug (s 
der hemip 
cimicidae). 


Flea (ann 
aphanipter 
family ) pu 



41 



CO 

w 

5 
w 

a 
w 


Male fern, pome- 
granate, pumpkin 
seeds, preceded by 
light diet for two 
days, and followed 
by cathartics. 


Ditto. 


CO 

5 

H 
U 

a 
u 


Length, 25 to 30 
feet. Head has two 
lateral grooves, but 
no hooklels. At- 
taches itself to mu- 
cous membrane by 
suckers. Not found 
in this country, ex- 
cept by importation. 
Derived from eating 
certain fish infected 
with the larvae. 


Length, 6 to 12 feet. 
Head about size of 
a pin, with four 
sucking disks and 
double row of hook- 
lets. Body jointed. 
Attains maturity in 
three to four months. 
Attaches itself to 
mucous membrane 
by suckers. Derived 
from eating pork 
containing scolices, 
which grow into 
taeniae in the human 
intestines. Two, 
three or more may 
occur. Common in 
United States. 


o 

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s g 

^ 

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Sill 

rrJ 

38-11 


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° 8 

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See T. Solium. 


Rare in this coun- 
try. When lodged 
in muscles no treat- 
ment will remove 
them; if few, and 
dying by calcifica- 
tion, no danger 
need be appre- 
hended. 


Longer and larger 
than T. Solium. 
Head square-shaped, 
having four large 
sucking disks with- 
out hooklets. At- 
taches itself to mu- 
cous membrane by 
suckers. Ripe seg- 
ments are passed as 
in the T. Solium. 
Derived in a similar 
manner to the T. 
Solium, substituting 
measly beef for 
pork. 


Consists of a minute 
taenioid head with 
a circlet of hooklets 
and four suckers 
united by a neck to a 
vesicular body. De- 
rived from the flesh 
of pig, or "measly 
pork." Develop- 
ment into taeniae 
takes place when 
the "measly pork" 
containing the scoli- 
ces reaches the small 
intestines of man; 
or the larvae instead 
may wander from 
the stomach by the 
blood and become 
encysted in the 
muscles, or under 
the skin. 


.5 

1/5 
V 

.s 
a 


Muscles, brain, con- 
nective tissue. 


Us 
.8 3 

5-1 


Cysticercus Cellu- 
loses, . (Larva of 
taenia solium). 


a. Taeniae (matured 
tape-worm). 

d. Taeniae (immature 
tape- worm.) 


I. Cestoidea, or 

tape-worms. 
(kegtoq, a band, and 

elSog, resemblance.) 


• 


° - 8 
.3 *S 

IT S se or 

~ s e a 



H 
2 

i 

W 

H 


u 

j&b 

Cu 3 

fa 

TD O 

O *_. 
Cu to 

o 2 
c 5 

co o 

^ s 

I 8 

ll 


c 

3 

t>~. 
u 

<u 
> 

o 

fc 

'/) 

<u 
T> 

"o 

jo 

s 

"C 

o c 

<i 

si 


Large injections with quassia, vinegar, 
salt and water, carbolic acid, aloes, dis- 
solved in suitable proportion. 


Purgatives within 1 to \]/ 2 days to evacu- 
ate the parasite, if it be known that tri- 
chinatous meat has been eaten. 


After reaching the human muscle medi- 
cines are without avail. One half to two 
per cent, of all bodies contain trichinae ; 
often occurs in epidemics. 


2 

3 
2 
o 

Q 
Z 
<! 

CO 

y 

2 

w 

H 

o 
<d 
Pi 
<J 

K 
U 


Length, male four to eight inches, female, 
seven to twelve. Is cylindrical and 
pointed at the extremities ; color, yellow- 
ish-brown ; is striated transversely ; usu- 
ally two to four present, but often in 
large numbers. Ova is expelled with 
faeces, the embryo being developed prior 
to its rupture. Its further history is un- 
known. Are most common in children. 


Length, one and one-half to two in.; 
male somewhat shorter. Anterior of 
body is attenuated and thread like. Ova, 
■fa in. in length, provided with button. 
Number present varies greatly. 


Length, male % in.; female, %; cy- 
lindrical and tapering. Occur at all 
ages, but most frequently in children. 


Length, female, J^in.; male, ^ — a hair- 
like worm, head smaller than body. De- 
veloped from trichinatous muscle (of 
pig) after introduction (3 to 7 days) into 
small intestines. The immature worms 
escape from their cysts, grow, develop 
sexual organs, producing progeny vivi- 
parously, which perforate the intestinal 
wall, working their way to the muscles, 
where they become encysted, remaining 
immature. 


Length, yq~^, tail pointed, head round, 
lies coiled in opaque ovid capsule, which 
becomes calcified, cooking (heat up to 
212 ) destroys the trichinatous meat. 
Unknown how pigs become diseased. 


2 

o 

u 
o 

1-1 


Small intestines, upper 
portion, but migrate 
into bile-ducts, stom- 
ach, oesophagus, etc. 


.2 

K> 

i3 
a 

C CO* 

5 ^ 


S3 
JO 

"o 
U 

a 

a 

3 
tS 
CJ 


^ 2 
to "55 


b. Trichinosis, (imma- 
ture or muscle-trichi- 
nae) ; voluntary mus- 
cles. 


w 
< 

o 
S 
S 
o 
U 


I. Ascaris lumbri- 
coides (common 
round worm). 


t/3 

15 
,a 

a, 

cu 
o 
o 

o . 


3. Oxyuris vermicu- 
laris (common thread 
worm). 


'a, 
a 

H 

4 


S5 

o 

> 




13 
C 

Si 

•ll 

cu cj 

s ~ 


13 

a 

* or 

ft- «o 







VII. LIST OF NEW REMEDIES UNDER TRIAL. 

Alumnol (see also p. 549). — In powder, 1 part, to starch 3 parts ; 
ointment I, to petrolatum 24, 12 or 0.8 ; solution, 1 to water, 4 parts. 
The ointment is serviceable in seborrhoic or vesicular eczema, ringworm 
and scabies. 

Analgene [C 9 H 5 (OC 2 H 5 )NH(COC 6 H 5 )N].— A chinoline derivative; 
is found in white, neutral, tasteless, insoluble crystals. Its action is 
antipyretic and antineuralgic. Dose, gr. viij, in powder, several times 
daily ; in 24 hours, gr. 40. 

Antitoxine. — This is an albuminous substance, obtainable in the 
form of powder or solution discovered in the blood of animals free 
from the diphtheritic virus or rendered immune to its action by the 
gradual introduction of this virus into the system. It is in the nature 
of a bacteriacidal or neutralizing agent against the toxines formed in 
or distributed through the body by diphtheria. Our knowledge of 
this subject is due to Behring, who originated the idea that it might be 
possible to produce this agent in a healthy animal and inoculate it 
upon another suffering from the disease. The horse, as he exhibits 
but slight diphtheritic susceptibility, has been the animal so far selected 
for experimentation. The process is as follows : (1) The making of a 
culture of virulent diphtheria bacilli in alkaline beef-broth. (2) By 
ten days a toxic flocculent precipitate is formed, the development 
of which is completed in about one month, when it is potent 
enough in the proportion of o.ic.c. to kill a guinea pig of 500 gm. in 
48 hours. The bacilli in this solution are next killed with 0.5 per 
cent, of carbolic acid, and sink to the bottom, the supernatant fluid 
being now ready for injection into a horse upon which the antitoxine 
treatment is to be performed. About 2c.c, gradually increased, of this 
fluid are injected into an animal free from disease ; after recovery, and at 
the end of three months serum obtained from this animal is sufficiently 
potent for use against diphtheria. Antitoxine gives prompt 
protection against the diphtheritic poison, thus differing from 
vacinia; but large amounts are required to obtain its remedial 
action. This protection is believed to last about three months, 
the substance then seeming to have been eliminated from the 
system* As regards the mortality under the antitoxine treatment, 

647 



648 APPENDIX. 

statistics are altogether in favor of its employment, the serum treat- 
ment having reduced the death-rate in some tables from fifty-one to 
twenty-five per cent. It seems to be best injected about three days 
after the onset of the disease, and is harmless. The dose for injection 
is about ioc. a, and so much as 90c. c. may be introduced in 24 hours. 

Benzosol (C 6 H 4 OCH 3 OCOC 6 H 5 ) or guaiacol " in which the 
hydrogen atom of hydroxyl is replaced by benzoyl." This is a color- 
less, tasteless, insoluble powder. Its advantage over guaiacol is 
freedom from taste, and it is prescribed in phthisis, its action depend- 
ing on guaiacol. Dose, gr. iv, t. d., given in powder, or in pastiles ; 
in 24 hours, gr. 12-36. 

Bromoform (CHBr), an analogue of chloroform. A clear, color- 
less liquid, almost tasteless, of peculiar, but not unpleasant odor ; 
insoluble in water, but miscible with alcohol. By inhalation it pro- 
duces effects similar to those of chloroform. Recommended in 
whooping cough. Dose, THj-iij for under 1 year ; 1-4, irftiv-v ; 5-7, 
TTtvi-vij ; all in water fgiv; in 24 hours, up to TTLxx. 

Creosote Carbonate, or Creosotal, an oily, yellow liquid of faint 
odor, is analagous to guaiacol carbonate, and is prepared from beech- 
wood creosote. As it is free from disturbing symptoms it is a conve- 
nient form of exhibiting creosote. Dose, children, TII3-5 ; adults, 
TTU5, t. d., in capsules. 

Europhen 2[CH 3 (QH 9 )C 6 H 3 0]HI, an iodoform substitute allied 
to aristol. An amorphous, yellow powder, of saffron-like odor, insolu- 
ble in water, but soluble in alcohol. It possesses kolyseptic action, 
and is employed as an iodoform substitute, being non-toxic, in luptis, 
ulcers, etc., applied by dusting it on or in 5 to 10 per cent, ointment. 

Euphorin (C 6 H 5 NHCOOC 2 H 5 ), phenyl-urethane. A white, crystal- 
line powder of faint aromatic odor and clove-like after-taste, insoluble 
in water, soluble in alcohol. It is antipyretic and antirheumatic, 
without unpleasant effects. Dose, gr. v-viij, 3 or 4 times daily, in tab- 
lets or suspended in water ; in 24 hours, gr. 20-30. 

Migranin, an antipyrine compound having the composition (uncer- 
tain in structure) of a double caffeine and antipyrine citrate. Highly 
recommended in migraine and headache. Dose, gr. xvij in water, just 
before attack. 

Orexine hydrochloride [C 6 H 4 (NCH)CH 2 NC 6 H 5 HCL], a complex 
chinoline derivative. Occurs in almost colorless, odorless crystals of 



APPENDIX. 649 

a pungent, bitter taste, soluble in hot water. Given in gastric catarrh 
and ulcer t and the vomiting of pregnancy. Dose, gr. v, in tablets. 

Piperazine (QH 10 N 2 ), a synthetic compound made by the action 
of ammonia on ethylene bromide or chloride. Occurs either as a 
solid or in lustrous tables, absorbing moisture readily and very solu- 
ble in water ; possesses the property of forming with uric acid a com- 
pound readily soluble in water, the piperazine urate formed being 
seven times more soluble than lithium urate; in addition it dissolves 
twelve times more of uric acid than lithium carbonate. Added to 
urine containing uric acid calculi it converts the undissolved portion 
into a soft, pulpy mass. It likewise exerts a solvent action upon 
urates and gouty tophi. It is well borne, being non-caustic, free from 
toxic effects, and can be injected into the bladder as a lithontriptic. 
It is taken up by the blood unchanged, and reaches the deposits unde- 
composed. Dose, gr. xv daily, in water largely diluted ; in 24 hours, 
gr. 45- 

Sulphaminol (C 10 H 4 OSNH), thio-oxy-di-phenylamine, a yellow 
powder without odor or taste, insoluble in water, but soluble in 
alkalies. Is non-toxic ; splits in the economy into oxydiphenylamine 
and sulphuric acid compounds. Has antiseptic properties and is used 
as a dusting powder upon ulcers, wounds, and in laryngo-rhinology. 

Symphorol, (Nasrol) caffeine sulphonate, a white, crystalline powder, 
odorless, of bitter taste, and soluble in water. Is a powerful diuretic 
without apparent influence on the blood-pressure or heart, the augment- 
ed urinary flow being due to the action of the caffeine on the nerve- 
centres and renal secretory cells. Dose, gr. xv, four times through 
the day, in water or capsules. Is entirely safe ; the sodium salt is the 
one usually employed, or Symphorol N. — A sodium caffeine sulpho- 
nate. 

Tussol, antipyrine-phenyl-glycolate, possesses a more favorable 
action than antipyrine in whooping cough. Dose, gr. ]—]}4, twice or 
thrice daily for infants of one year; of four, gr. viij, repeated. 



INDEX OF DISEASES AND REMEDIES. 



/ 



ABORTION. 

Cold water, uterine injection, 37. 
Cotton-root bark, to stop haemorrhage, 

276. 
Cotton tampon, medicated, 598. 
Ergot, to stop the bleeding after, 293. 
Opium and belladonna suppository, to 

relieve pain, 91. 
Viburnum prunifolium, as a sedative, 

319- 
ABORTIFACIENTS. 
Elaterin, 372. 
Jalap, 362. 
Rue, oil of, 425. 
Savine, 424. 
Scammony, 368. 
ABRASION. 

Adhesive plaster, 594; court-plaster, 

59+- 

Collodion, 594. 

Liquor gutta-perchae, 593. 

Petrolatum and carbolic acid, 590. 

Styptic collodion^ 596. 
ABSCESS. 

Aspiration, 31. 

Belladonna, topically, 102. 

Boric acid solution, injected, 506. 

Carbolic acid injection, 513; as dress- 
ing, 5 1 5- 

Cocaine to relieve pain of dental, 140. 

Cocaine, hypodermically, in abscess 
before opening, 140. 

Corrosive sublimate solution injected 
into, 501. 

Hops fomentation, 114. 

Hyoscyamus, topically, 108. 

Iodine tincture in forming stage, 460. 

Lead acetate lotion, 194. 

Leeches to prevent formation of, 28. 

Malt liquors, 216. 

Opium ointment to relieve pain, 91. 

Potassa sulphurata in scrofulous, 339. 

Potassium permanganate solution in- 
jected in cavity of, 499. 

Poultice, 570. 

Sulphides to check suppuration, 505. 

Syrupus calcii lactophosphatis, 478. 



ACIDITY. 

Alkalies, 483. 

Alkaline mineral waters, European, 
490; North American, 489. 

Ammonium preparations, 493. 

Calcareous waters, 496. 

Calcium preparations, 494. 

Hunyadi Janos water, 352. 

Lactic acid before meals, 175. 

Leamington water, 352. 

Lithian mineral waters, 493. 

Lithian preparations, 492. 

Potassium preparations, 484. 

Saratoga waters, 349. 

Sodium preparations, 487. 
ACNE. 

Arsenic, 474. 

Borax lotion, 507. 

Carbolic acid, 514. 

Citrine ointment, 457. 

Icthyol, 548. 

Liquor potassse, topically if skin be 
greasy, 485. 

Nitric acid, 172. 

Scarification, 28. 

Sulphur ointment, 338. 

Sulphur iodide ointment, 466. 

Sulphur mineral waters, 340-341. 
ADENITIS (see also Abscess). 

Belladonna ointment to relieve 



pain, 



104. 



Iodine tincture, topically, 460. 

Leeches to prevent formation of, 28. 

Poultices, 570. 
ADYNAMIA (see Asthenia). 
AFTER-PAINS. 

Cimicifuga, 287. 

Ergot to induce uterine contraction and 
expel clots, 273. 

Morphia or atropia, 90. 

Quinine, 160. 

Viburnum prunifolium, 319. 
ALBUMINURIA (see also Bright's 
Disease). 

Basham's mixture, 434. 

Chalybeate mineral waters, 437-438. 

651 



652 



INDEX OF DISEASES AND REMEDIES. 



ALBUMINURIA (continued). 

Milk diet (see Dietary, in Appendix). 

Strontium lactate, 1 76. 

Tannic acid, 181. 
ALCOHOLISM. 

Acidum hydrobromicum dilutum, 302. 

Ammonia, aromatic spirits of, 219. 

Capsicum as substitute for liquor, 
223. 

Liquor ammonii acetatis to remove 
effects of, 256. 

Potassium bromide to quiet excitement, 
298. 

Strychnine, hypodermically, 264, 637. 

Strychnia in paralysis from, 263. 

Sulphonal as hypnotic, 97. 
ALOPECIA. 

Alcohol and ammonia lotion, 214. 

Cantharidal preparations, 560. 

Dupuytren's pomatum, 560. 

Green soap, 567. 

Iodized collodion, 595. 

Pilocarpine, 380. 

Quinine lotion, 1 61. 
AMAUROSIS. 

Faradization, 45. 

Mercurials, 422. 

Potassium iodide if syphilitic, 463. 

Strychnine, hypodermically, 264-5, 
637- 
AMENORRHEA. 

Aloes, 357. 

Aloes and iron pills, 352. 

Ammonium chloride, 220. 

Apiol, 426. 

Guaiac, 383. 

Hot sitz-bath with mustard before 
period, 33. 

Mustard sitz-bath, warm, in delayed, 

553- 

Myrrh, 419. 
Myrrh and Aloes, 419. 
Potassium permanganate, 498. 
Rufus's pills, 357. 
Rue, oil of, 425. 
Sabina, 424. 
Sanguinaria, 329. 
ANEMIA. 

Arsenic, iron and quinine, 475. 
Chalybeate natural waters, European, 
• 438. 

Chalybeate natural waters, North 

American, 438. 
Cream. 

Dialyzed iron, 437. 
Ferric chloride tincture, 433. 
Ferrous sulphate, 431. 
Ferrum reductum, 429. 
Fowler's solution, 476. 
Iron preparations, 428. 
Massage, 47. 



ANEMIA (continued). 

Nourishing diet (see Dietary in Ap- 
pendix). 

Pancreatin, 167. 

Pepsin, 166. 

Red wines, 215 (see Appendix for 
strength of). 

Saratoga waters containing iron, 349. 

Strychnine and iron, 264. 

Syrupus calcii lactophosphatis, 478. 
ANEMIA, PERNICIOUS. 

Arsenic the best remedy, 475. 

Phosphorus, 179. 
ANASARCA (see Ascites and Drop- 
sy). 
ANEURISM. 

Aconite to moderate cardiac action, 240. 

Aliment, low (TuffneH's). 

Electrolysis, 46. 

Lead acetate, 194. 

Potassium iodide in large doses, 464. 

Rest very important. 
ANGINA PECTORIS: Attack. 

Ferric chloride tincture, 433. 

Fowler's solution, 475. 

Galvanism, 44. 

Nitrites, potassium and sodium, 315. 

Nitroglycerin, 314. 

Phosphorus, 179. 
ANGINA PECTORIS: Seizure. 

Amyl nitrite to relieve pain, etc., in- 
haled from crushed capsule, 312. 

Ether, as antispasmodic, 116. 

Lobelia, 305. 

Morphia, hypodermically, 90. 
ANIDROSIS. 

Frictions, 29. 

Hot-air bath, 34. 

Pilocarpine, 380. 

Warm bath, 33. 
ANOREXIA. 

Alcohol, 214. 

Berberine, 148. 

Cascarilla, 153. 

Chirata, 148. 

Calumba, 147. 

Eriodyction, 154. 

Eupatorium, 152. 

Ferrous carbonate, saccharated, 430. 

Gentian, 146. 

Quassia, 145. 

Quinine, 160. 

Serpentaria, 148. 

Strychnine, 264; with phosphoric acid, 
265. 
ANTHRAX (see Carbuncle). 
ANTIDOTES (see index for each 

drug). 
APHONIA (see Hoarseness). 

Hysterical, electricity, 45. 



INDEX OF DISEASES AND REMEDIES. 



653 



APHTHA (see also Stomatitis). 

Boric acid, 506 ; against thrush, 506. 

Borax, 507 ; as spray to thrush, 507. 

Catechu troche, 184. 

Copper sulphate, topically, 198. 

Potassium chlorate solution, mouth 
wash, 487. 

Potassium permanganate spray in 
thrush, 499. 

Sodium sulphite, spray for thrush, 504. 
APOPLEXY. 

Aconite, to control circulation, 238. 

Blood letting, 27. 

Croton oil in cephalic congestion and 
strong, full pulse, 374. 

Faradization, 45. 

Jalap, 362. 

Scammony, 368. 

Sinapism to nape of neck, 552. 

Stimulants as alcohol, 214; ammo- 
nia, 218 ; and ether, 1 16, to sustain 
heart in thrombosis and embolism. 

Strychnia in paralysis from, 263. 
APPENDICITIS (see Typhlitis). 
ARTERIO-SCLEROSIS. 

Nitroglycerin to relieve tension of the 
vessels, 314. 

Potassium iodide, 464. 
ARTHRITIS DEFORMANS (see 

Rheumatic Arthritis). 
ASCARIDES (see Worms). 
ASCITES. 

Aspiration, 31. 

Colocynth, 370. 

Croton oil, 374. 

Digitalis, if due to heart disease, 280. 

Elaterin, 372. 

Ferric chloride tincture, 433. 

Jalap, 362. 

Juniper with potassium bitartrate, 398. 

Podophyllum, 365. 

Potassium acetate, 388. 

Scammony, 368. 
ASPHYXIA. 

Alcohol, 213. 

Ammonia water, 218. 

Cold affusions to arouse from, 36. 

Electricity, 41. 

Hot bath, 33. 
ASTHENIA. 

Alcohol, 213. 

Cod liver oil, 468. 

Diet : nourishing of first importance 
(see Dietary in Appendix). 

Ferrous carbonate, saccharated, 430. 

Malt extract, 2 1 6. 

Malt liquors, 216. 

Pancreatin, 167. 

Quassia, 145. 

Quinine, 160. 

Wine, 215. 



ASTHMA. 

Amyl nitrite to relieve dyspnoea, 312. 

Antipyrine to ward off attack, 537. 

Aspidosperma, 322. 

Atropine sulphate to prevent parox- 
ysm, 102. 

Chloroform, by inhalation, to relieve 
paroxysm, 122. 

Conium, 289. 

Diet of liquid food to avoid distend- 
ing alimentary canal (see Dietary 
in Appendix). 

Ether as antispasmodic, 116. 

Etherization to control paroxysm of, 
219. 

Grindelia, 32 1. 

Hydrocyanic acid, dilute, 309. 

Hyoscine hydrochlorate, 109. 

Lobelia, 305-6. 

Morphine, hypodermically to relieve 
paroxysm, 90, 637. 

Nitrites, potassium and sodium, 315. 

Nitroglycerin, 314. 

Nitrous papers, fumes of, inhaled, 255. 

Pilocarpus, 380. 

Potassium iodide, 464. 

Quinine, 160. 

Sodium arsenate cigarettes, 477. 

Stramonium leaves, smoked, 106. 

BALANITIS. 

Alumnol, 549. 
Black wash, 448. 
Carbolic acid lotion, 515. 
Dermatol, 549. 
Iodoform dressing, 541. 
Scarifications to relieve oedema, 28. 

BALDNESS (see Alopecia). 

BASEDOW'S DISEASE (See Ex- 
ophthalmic Goitre). 

BED-BUGS (see Appendix for Para- 
sites, p. 64i). 

Corrosive sublimate solution, scouring 
bed with, 502. 

Sulphur fumigation, ^^8. 

BED-SORES. 

Alcohol lotion to harden parts, 214; 

with white of egg, 215. 
Alum lotion, 208. 
Condy's fluid to clean parts, 499. 
Liquor gutta-perchae as protective, 593. 
Poultices to remove sloughs, 570. 
Soap-plaster in threatened, 196. 
Stramonium, topically, 106. 
Zinc oxide ointment to keep parts 

supple, 199. 

BELL'S PALSY (see Facial Para- 
lysis). 

BILIARY CALCULI (see Calculi). 



654 



IXDEX OF DISEASES AND REMEDIES. 



BILIOUSNESS (meaning anorexia, 
furred tongue, nausea, headache 
and constipation). 

Blue mass and a saline cathartic, 445. 

Diet, light, and easily assimilated (see 
Dietary in Appendix). 

Jalap, 362. 

Magnesia as antacid and laxative, 343. 

Seidlitz p wder, 348. 

BITES OF INSECTS, ETC. (See 
Virus of Venomous Animals). 

BLADDER, IRRITABILITY OF. 

Ammonium benzoate if urine be alka- 
line, 525. 
Anodyne enemata, 377. 
Antacids, 484-496. 
Belladonna suppository, 103. 
Cocaine urethral bougie, 139. 
Couch grass to allay urinary irritation, 

398- 
Naphthalin, 534, and Salol, 532, to 

prevent decomposition of urine. 
BLEPHARITIS. 

Boracic acid ointment, 508; glycerite 

of boroglycerin, 507. 
Sodium carbonate solution, to remove 

crusts of, 489. 
Yellow mercuric oxide ointment, 448. 

BLISTERED SURFACES (see also 
Excoriated Surfaces). 

Cold cream, 189; court plaster, 594. 

Goulard's cerate, 195. 

Resin cerate, 594. 

Petrolatum, 590. 

Yellow mercuric oxide ointment, 448. 
BOILS. 

Arsenic, 474. 

Belladonna, topically, 102. 

Emplastrum opii to relieve pain, 92. 

Iodine tincture, topically, 460. 

Lead acetate lotion, 194. 

Opium ointment to relieve pain, 91. 

Poultice, if suppuration be impending, 
570- 

Sulphides, 505. 

Sulphurous waters, in chronic cases, 

341. 
Vichy water, in chronic cases, 490. 

BREATH, FETOR OF. 

Borax mouth wash, 507. 
Carbolic acid mouth wash, 515. 
Lime water mouth wash, 495. 
Myrrh and carbolic mouth wash, 419. 
Potassium permanganate mouth wash, 

499- 
Salicylic acid mouth wash, 530. 

BRIGHT'S DISEASE, ACUTE (see 
also Uraemia). 
Cupping, wet or dry, in first stage, 28. 
Digitalis to relieve dropsy, 281. 



BRIGHT'S DISEASE, ACUTE 

(continued). 
Milk diet (see Dietary in Appendix). 
Nitroglycerin, early, to depress arterial 

tension, 314. 
Potassium bitartrate as hydragogue 

and diuretic, 348. 
Saline cathartics to remove dropsy, 

343, et. al. ; concentrated, 344. 
BRIGHT'S DISEASE, CHRONIC 

(see also Uraemia). 
Aspiration to remove dropsy, 31. 
Auri et sodii chloridum, 458. 
Basham's "mixture, 434. 
Capon Springs water, 490. 
Cupping to relieve convulsions of, 28. 

} Aspiration for deep, 31. 
Scarifications for super- 
ficial, 28. 
Digitalis, to relieve dropsy, 281. 
Elaterin, 372. 

Gallic acid, to lessen albumen, 182. 
Hot-air bath as diaphoretic, 34. 
Jalap, 362. 
Juniper with potassium bitartrate, an 

active diuretic, 398. 
Magnesium sulphate to remove dropsy, 

344- 
Milk diet (see Dietary in Appendix). 
Pilocarpus to remove dropsy, 380. 
Poland Spring water, 490. 
Potassium bitartrate, 348. 
Scammony, 388. 
Scoparius, 399. 
Strontium lactate to lessen albumen, 

X 7 6 ' 
Tannic acid to lessen albumen, 181. 

BRONCHITIS, ACUTE. 

Aconite, given early, 239. 

Ammonium chloride, 220. 

Brown mixture, 580. 

Burgundy pitch plaster, 554. 

Croton oil applied to chest, 374, 561. 

Dover's powder as anodyne diapho- 
retic, 92. 

Eucalyptus oil, 150. 

Eupatorium in later stage, 152. 

Friction with liniment to chest, 29. 

Grindelia, 321. 

Hydrocyanic acid, dilute, 309. 

Ipecac, 326-7. 

Mustard and warm water foot-bath, 
at onset, 553. 

Opium or morphia for cough, 90. 

Paregoric, 92. 

Prunus virginiana, 165. 

Sanguinaria, 329. 

Senega, 402. 

Sinapism to chest, 552. 

Squill syrup, 391. 

Tar vapor, 409. 

Tartar emetic in early stage, 25 1-2. 



INDEX OF DISEASES AND REMEDIES. 



655 



BRONCHITIS, ACUTE (continued). 

Terebene,4o8. 

Turpentine stupes to chest, 407. 

Vinum antimonii, 252. 
BRONCHITIS, CAPILLARY. 

Alcohol, 214. 

Ammonium carbonate, 221 ; iodide, 
465- 

Apomorphine emetic, 330. 

Ipecac as expectorant and emetic, 326. 
BRONCHITIS, CHRONIC. 

Alum solution, atomized, 208. 

Ammoniac, 128. 

Ammonium carbonate, 221 ; iodide, 
465. 

Brown mixture, 580. 

Burgundy pitch plaster, 554. 

Cimicifuga, 287. 

Creosote, 517. 

Eucalyptus oil, 150. 

Grindelia, 321. 

Iodine tincture to chest, 460. 

Iodine vapor, inhaled, 460. 

Senega, 402. 

Squill, 390-91. 

Strychnine to relieve dyspnoea, 264. 

Tar syrup, 409. 
. Tar vapor, 409. 

Terebene, 408. 

Warming plaster, 555. 
BRONCHOCELE (see Goitre). 
BRUISES (see also Wounds). 

Arnica lotion, 247. 
BUBO. 

Aspiration, 31. 

Carbolic acid dressing, 515. 

Corrosive sublimate solutions, cotton, 
gauze, lint, etc., 502. 

Dermatol, 549. 

Hydrogen peroxide dressing, 503. 

Iodine tincture with rest, 460. 

Iodoform, 541. 

Iodol, 545. 

Leeches, early, 28. 

Peppermint oil as antiseptic dressing, 
232. 

Potassium permanganate solution in- 
jected into cavity, 499. 

Poultices when suppuration is- un- 
avoidable, 569-70. 

Pressure to cause subsidence. 

Rest, absolute. 
BURNS. 

Boric acid dressing, 506. 

Carbolic acid dressing, 515. 

Carron oil or lime liniment, 495, 575. 

Goulard's cerate, 195. 

Glycerin, lint and cold cream, 588. 

Iodoform paste, 541. 

Resin cerate, 594. 

Salol, olive oil and lime water, 533. 

Sodium carbonate sprinkled over, 489. 



BURSA, DISEASES OF. 

Aspiration to remove fluid, 31. 

Bandage to promote absorption, 28. 

Carbolic acid by injection, 513. 

Cocaine, hypodermically before open- 
ing, 140. 

Iodine tincture, topically, 460. 

Poultice, 570. 
CACHEXIA. 

Cod liver oil, 468. 

Fresh air with appropriate exercise. 

Iron preparations, 429. 

Massage, 47. 

Nutritious aliment (see Dietary in 
Appendix). 

Sarsaparilla, 382. 
CALCULI/BILIARY. 

Aliment : avoid starchy and farina- 
ceous foods (see Dietary in Appen- 
dix). 

Capon spring water, 490. 

CarLbad water, 352. 

Castor oil purge, 336. 

Etherization to relieve pain of, 119. 

Hot bath during passage of, 34. 

Michigan Congress Springs water, 349. 

Morphine, hypodermically, 88, 637. 

Poland spring water, 490. 

Sodium phosphate to promote solu- 
tion, 347. 

Vichy water, 491. 
CALCULI, RENAL. 

Aliment : restricted ; see gout. 

Calcareous waters, 496. 

Capon spring water, 490. 

Carlsbad water, 352. 

Contrexville water, 496. 

Etherization to relieve pain of, 1 19. 

Fachingen water, 491. 

Hot bath during passage of, 34. 

Morphia, hypodermically, 88. 

Piperazine as uric acid solvent (see 
Appendix p. 649). 

Poland spring water, 490. 

Potassium acetate to neutralize urine, 
388; citrate, 255. 

Sprudel water, 352. 

Vichy water, 491. 

Wildungen water, 496. 
CANCER. 

Aristol, 543. 

Arsenous acid, topically, 475. 

Bromine, 565. 

Iodoform to relieve pain, 541. 

Rectum of, anodyne enemata, 377. 
CANCER OF STOMACH. 

Bismuth subnitrate to check vomiting, 
206. 

Chloroform to relieve pain and vomit- 
ing, 122. 

Lavage to combat vomiting, 31. 

Nutrient enemata, 377. 



656 



INDEX OF DISEASES AND REMEDIES. 



CANCRUM ORIS. 

Actual cautery, 34. 
Nitric Acid, 172. 
Poultice, 570. 
Silver nitrate, 562. 
CARBUNCLE. 

Belladonna, topically, 102. 
Carbolic acid dressing, 515. 
Caustic potassa, 563 ; soda, 563. 
Corrosive sublimate solution, 501. 
Escharotics, 562 et al. 
Iodine tincture, topically, 460. 
Opium ointment to relieve pain, 91. 
Potassium permanganate dressing, 499. 
Poultice, 570. 
Sulphides, 504-5. 
CARDIAC DISEASES (see Heart, 

etc.). 
CATARACT. 

Atropine solution to eye, in diagnosis 

of, 103. 
Cocaine, topically, 140. 
Duboisine for ocular examination in, 

no. 
Surgical interference or lenses is the 

appropriate treatment. 
CATARRH, ACUTE NASAL (cold 

in the head). 
Aconite given early to abort, 239. 
Camphor snuff, 130. 
Cocaine to nasal mucous membrane, 

140. 
Dobell's solution, 78. 
Dover's powder, early, 92. 
Iodine vapor, inhaled, 460. 
Lemonade, hot, in bed, at onset, 259. 
Menthol, as spray, 232. 
Mustard and water to feet at onset, 

. 553- . 

Silver nitrate to post-nasal space, 203. 

Sodium carbonate, borate and chloride 
solution, as nasal douche, 489, or 
the first alone in tepid water, 489. 

Tar water spray, 409. 

Veratrum viride, 244. 
CATARRH, CHRONIC NASAL. 

Borax and glycerin douche, 507. 

Carbolic acid spray, 514. 

Cocaine, topically, to relieve occlu- 
sion, 140. 

Dobell's solution to cleanse nostrils, 
78. 

Galvano-cautery to remove hypertro- 
phied tissues, 46. 

Glycerin to soften dried mucus, 58S. 

Hot water nasal douche, ^. 

Mackenzie's alkaline wash, 489. 

Menthol spray, 232. 

Petrolatum to soften scales, 590. 

Silver nitrate in solution to post-nasal 
space, 203. 



CATARRH, CHRONIC NASAL 

(continued). 

Tannic acid douche, 181. 

Tar water spray, 409. 

Zinc sulphate, nasal douche, 199. 
CEPHALALGIA (see Headache). 
CEREBRAL ANEMIA. 

Alcohol, 213. 

Ammonia water or aromatic spirit of, 
218-19. 

Faradization, 44. 

Ferric chloride tincture, 433. 

Recumbent posture. 
CEREBRAL HYPEREMIA. 

Aconite, 240. 

Cold water compress or ice bag, 36. 

Elevating head. 

Ice-cap, 36. 

Jalap, 362. 

Magnesium sulphate, 344. 

Potassium bromide to lessen cerebral 
blood-supply, 298. 

Scammony, 368. 
CEREBRO-SPINAL MENINGITIS 
(see also Meningitis Cerebral). 

Aconite to diminish frequency and 
force of cardiac action, 239—40. 

Alcohol to arouse from collapse, 214. 

Blister to nape of neck, 559. 

Ice-bag to spine, 36. 

Magnesium sulphate, 344. 

Opium to relieve pain, 89. 

Potassium iodide in latter stage, 464. 

Sinapism to nape of neck, 552. 
CHAFING. 

Bismuth subnitrate and camphor, 206. 

Lycopodium, 596. 

Of tender feet, soaking in hot water 
with potash nitrate, ^^- 

Magnesium carbonate, 344. 

Prepared chalk, 495. 

Starch powder, 583. 

Talc, 596. 
CHANCRE AND CHANCROID. 

Aristol, 543. 

Black wash, 448. 

Carbolic acid, 514-515. 

Dermatol, 549. 

Iodoform, 541. 

Iodol, 545. 

Liquor hydrargyri nitratis, 457. 

Yellow wash, 448. 
CHAPS. 

Bismuth oleate, 206. 

Camphor cream, 131. 

Cold cream, 189. 

Glycerin, 588. 

Petrolatum, 590. 

Theobroma, oil of, 5 8 7. 

Zinc oxide ointment, 200. 
CHICKEN POX (see Varicella). 



INDEX OF DISEASES AND REMEDIES. 



657 



CHILBLAIN. 

Belladonna ointment to relieve pain, 
104. 

Chloroform liniment, 123. 

Cold affusions with friction, to revive, 
36. 

Icthyol, 548. 

Iodine tincture topically, 462. 

Linimentum saponis, 131. 

Zinc oxide ointment, 199. 
CHLOROSIS. 

Diet, nourishing (see Dietary in Ap- 
pendix). 

Ferric lactate, 435. 

Ferrum reductum, 429. 

Fowler's solution, 476. 

Iron and arsenic, 429. 

Iron preparations, 428. 

Quassia, 145. 

Strychnine and iron, 264. 
CHOLERA, ASIATIC. 

Acid sulphuric, dilute, 171. 

Baths, hot bricks, etc., in algid stage, 33. 

Calx chlorata 4 per cent, for excreta, 
500. 

Camphor in initial stage, 129. 

Carbolic acid crude for excreta (1 to 
20), 515. 

Chloroform, 122. 

Corrosive sublimate solution I to 500 
for excreta, 501. 

Ice melted in mouth to allay thirst, 37. 

Lead acetate and opium, 194. 

Opium in early stage, 88. 

Sinapism to epigastrium, 552. 

Sulphurous acid as disinfectant, 504. 

Zinc chloride solution I to 10 for 
excreta, 200. 
CHOLERA INFANTUM. 

Castor- oil purge, -336. 

Chlorodyne (foot-note), 123. 

Haematoxylon, 186. 

Ice melted in mouth, to allay thirst, 3J. 

Paregoric, 92. 
CHOLERA MORBUS (see also C. 
Asiatic). 

Calomel, 450. 

Castor-oil purge given early, 336. 

Chlorodyne (foot-note), 123. 

Lead acetate and opium, 194. 

Morphia, hypodermically, for griping 
pain, 90, 637. 

Opium in early stage, 88. 

Sinapism to epigastrium, 552. 
CHORDEE. 

Camphor, 130. 

Hops, 114. 

Ice-cold water in bottle to perineum, 37. 

Lupulin, 114. 

Morphia, hypodermically, the best rem- 
edy, 90, 637. 
42 



CHORDEE (continued). 

Opium and belladonna suppository to 
check, 91-102. 

Potassium bromide, 300. 
CHOREA. 

Arsenic, the remedy, 474. 

Cimicifuga, 287. 

Cold affusions to check movements, 35. 

Ether-spray to spine, 35. 

Etherization to prevent attack, 1 19. 

Exalgine, 523. 

Hydrobromic acid, dilute, 302. 

Hyoscyarriinae sulphas, 108. 

Iron preparations, 429. 

Potassium bromide, 299. 

Zinc sulphate, 199. 

CIRRHOSIS (see Liver, affections of). 
COLD IN HEAD (see Catarrh, acute 

nasal). 
COLIC, BILIARY (see Calculi, Bili- 
ary). 
COLIC, INTESTINAL. 
Asafcetida in flatulent, 127. 
Castor-oil purge, 336. 
Chloroform as anodyne and antispas- 
modic, 122. 
Ether as antispasmodic, 116. 
Ginger, 227. 

Morphia, hypodermically, 88, 637. 
Sinapism to epigastrium, 552. 

COLIC, NEPHRITIC (see Calculi, 

Renal). 
COLICA PICTONUM. 

Belladonna as antispasmodic, 102. 

Hot-bath as eliminator, 34. 

Magnesium sulphate, 344. 

Potassium iodide as eliminator, 464. 

Prophylaxis most important. 

Sulphur waters, 34C-I. 

Treatment of, 193. 
COLLAPSE. 

Alcohol, hypodermically, 214. 

Ammonia preparations, 218-19. 

Brandy, 216. [636. 

Cocaine injection to sustain heart, 141, 

Hot bottles, blanket, etc., in algid 
stage, 33. 
COMA. 

Blisters, 556. 

Cold affusions to arouse from, 36. 

Electro-magnetic battery, 87, under 
opium-poisoning. 

COMEDONES. 

Green soap, 567. 
CONDYLOMATA. 

Black wash, 448. 
Carbolic acid, as cauterant, 514. 
Copper sulphate, 198, 566. 
Silver nitrate, topically, 203, 562. 



658 



INDEX OF DISEASES AND REMEDIES. 



CONJUNCTIVITIS. 

Alum collyrium, 208. 

Boric acid collyrium, 54.6. 

Cocaine collyrium, 140. 

Cold water bathing of eyes for photo- 
phobia, 36. 

Gonorrhceal, ice-water compress to 
orbits, 37. 

Iodol in chronic, 545. 

Resorcin collyrium, 527. 

Scarifications, 28, 

Silver nitrate collyrium, 203. 

Tannic acid collyrium, 181. 

Tricresol water to preserve collyria,5i9. 

Zinc sulphate eye-wash, 199. 
CONSTIPATION. 

Aloes, 356-7. 

Aloin, 357. 

Asafoetida enema, 127. 

Belladonna, aloin and nux vomica in 
habitual, 102. 

Blue mass, 375, 445. 

Calomel, 374, 450. 

Carlsbad water, 352. 

Cascara sagrada, 360. 

Castor oil, 336. 

Colocynth, 370. 

Compound cathartic pills, 371. 

Confection of senna, 358. 

Croton oil, 374. 

Electricity, 44. 

Enemata, purgative, 375. 

Epsom salt, 344. 

Friedrickshall water, 352. 

Glycerin enema, 588. 

Gray powder, 447. 

Homburg water, 351. 

Hunyadi Janos water, 352. 

Hyoscyamus, 108. 

Lady Webster pill, 357. 

Laxatives as the fig, tamarinds, fruits, 
molasses, cassia fistula, etc., 332-3. 

Leamington water, 352. 

Magnesia, 343. 

Magnesium carbonate, 344. 

Magnesium citrate, solution of, 345 ; 
effervescent, 345. 

Magnesium sulphate, 344. 

Manna, 333. 

Massa hydrargyri, 375, 445. 

Mercurial preparations, 444. 

Nux vomica in chronic, 264. 

Podophyllum, 365. 

Rhubarb, 355. 

Saratoga waters, 349. 

Seidlitz powder, 348. 

Soap and warm water enema, 566. 

Sulphur, 338. 

Suppositoria glycerini, 589. 

Vegetable cathartic pills, 370. 

Water, tumblerful of, before breakfast, 
572. 



CONVALESCENCE. 

Alcohol, 214. 

Cascarilla, 153. 

Chirata, 148. 

Diet : easily assimilated and nourish- 
ing (see Dietary in Appendix). 

Gentian, 146. 

Malt liquors, 216. 

Quassia, 145. 

Quinine, 160. 

Wine, 215. (See Appendix for list 
of, 637). 
CONVULSIONS. 

Chloral, 295. 

Emetic if stomach be overloaded, 
324 et al. 

Etherization to prevent, 119. 

Ice-bag to spine in infantile, 36. 

Potassium bromide in infantile, 299. 

Warm bath in infantile, 33. 
CONVULSIONS, UREMIC (See 

Uraemia). 
CORNEA, OPACITY OF. 

Calomel, topically, 451. 

Cod liver oil, topically, 468. 

Iodol, 545. 

Yellow mercuric oxide ointment, 448. 
CORNS (see Tylosis). 
CORYZA (see Catarrh, Acute Nasal). 
COUGH. 

Alum solution to throat, 208. 

Brown mixture, 580. 

Cocaine to throat, 140. 

Codeine, 93. 

Liquorice lozenge for pharyngeal, 579. 

Hydrocyanic acid, dilute, 309. 

Opium or morphia, 90. 

Potassium bromide, 298. 

Potassium chlorate lozenge, 481. 

Terebene, 408. « 

Tolu balsam inhalation, 422. 

Wild cherry, 165. 

Wistar's lozenge in laryngeal or pha- 
ryngeal, 91-2. 
CROUP. 

Alum emetic. 208. 

Ipecac emetic in spasmodic, 326. 

Lactic acid, topically, 176. 

Lime solution, atomized in membra- 
nous, 495. 

Sanguinaria emetic, 329. 

Sinapism to skin over larynx, 552. 

Squill as emetic, 391. 

Warm bath, 33. 

Yellow mercuric sulphate as emetic, 

457- 
CYSTITIS, ACUTE. 

Abstinence from alcoholic stimuli, 

210. 
Anodyne enemata, 377. 
Barley w r ater, 576. 



INDEX OF DISEASES AND REMEDIES. 



659 



CYSTITIS, ACUTE (continued). 
Belladonna suppository, 103. 
Baths, hot hip, 33. 
Demulcents, 569, et al. 
Opium and belladonna suppository, 

91. 
Hot bath to relieve strangury, 33. 
Hyoscyamus tincture, occasionally 

useful, 108. 
Linseed tea, 575. 
Liquor potassse to neutralize urine, 

485, or sodse, 488. 
Milk and apollinaris, 572. 
Salol to prevent decomposition of 

urine, 532. 
Slippery-elm infusion, 577. 

CYSTITIS, CHRONIC. 

Barley water, 576. 

Benzoin, 420 ; Benzoic acid, 524. 

Boric acid, 506. 

Buchu, 416. 

Calcareous waters, 496. 

Capon Springs water, 490. 

Contrexville water, 496. 

Ems water, 491. 

Eucalyptus, 150. 

Hot water to wash out bladder, 33. 

Linseed tea, 575. 

Liquor Potassae to neutralize uriifc, 

485. 

Naphthalin, 534. 

Pareira, 415- 

Regular catheterization. 

Slippery-elm infusion, 577. 

Triticum, 398. 

Uva Ursi, 417. 

Vesical injections of acid carbolic, 
TTLij to tepid water f Jiv; or Borax 
gr.viij — xx, glycerin f^ij, and tepid 
water fjiv; or lead acetate gr.yi 
in tepid water f^ii-iv; or simple 
tepid water. 

Vichy water, 491. 

Zea, 399. 

DELIRIUM TREMENS. 

Alcohol to "taper off with," 214. 

Chloral, 295. 

Digitalis in large doses, 281. 

Morphia, hypodermically, the remedy, 
88, 6 37 . 

Opium or morphia as hypnotic, 88. 

Paraldehyde to procure sleep, 95. 

Potassium bromide to remove delu- 
sions and procure sleep, 298, 

Sulphonal, 97. 

DENGUE. 

Antipyrine for pains, 537. 
Opium to relieve bone-pains, 88. 
Quinine to relieve bone-pains, 161. 
Salicylic acid or sodium salicylate, 
530. 



DERMATITIS VENENATA. 

Aristol, topically, 543. 
Grindelia, topically, 321. 

DIABETES INSIPIDUS. 

Diet, absence of fluids. 

Ergot one of the best remedies, 274. 

Valerian decreases urinary flow, 132. 

DIABETES MELLITUS. 

Capon Springs water, 490, 

Carlsbad water, 352. 

Codeine to lessen sugar in urine, 93. 

Diet of first importance : avoid all 
sugary and farinaceous articles, as 
sugar, wheat-bread, rice and pota- 
toes; substitute saccharin (592), 
gluten, almond and bran-bread and 
green vegetables; meats may be 
eaten freely. Wines (except claret, 
dry sherry, hock), liquors (except 
whiskey \ and beers, prohibited. 
Tea, coffee, and cocoa (made from 
nibs) permitted. 

Fowler's solution, 476. 

Friedrickshall water, 352. 

Lime preparations, 495. 

Morphia, 90. 

Poland Spring water, 490. 

Saccharin, 592. 

Sprudel water, 49 1. 

Vichy water, 491. 

DIARRHOEA, ACUTE. 

Bismuth preparations, 206. 

Calomel in infantile cases, 451, 

Calumba, 147. 

Camphor, 130. 

Castor oil, 337. 

Catechu and morphia, 1 84, or chalk 

mixture, 495. 
Chalk mixture, 495 ; with laudanum 

or catechu, 495. 
Charcoal, 597. 
Chlorodyne (footnote), 123. 
Chloroform, capsicum and morphia, 

122. 
Diet : Milk, arrowroot, boiled rice, 

eggs, sago, tapioca and clear soup 

(see Dietary in Appendix). 
Dover's powder in early stage, 92. 
Hope's camphor mixture, 130. 
Lime water, 495 ; syrup, 495. 
Mineral Acids, 170; astringents, if 

obstinate, 193, et al. 
Opium in early stage, 89. 
Pepsin, 166. 
Prepared chalk, 495. 
Quassia, 145. 
Rhubarb, 355. 
Rubus villosus, 190. 
Salol, if stools be fetid, 532, 
Sulphuric acid, dilute, 1 7 1. 
Tannic acid, 181. 



660 



INDEX OF DISEASES AND REMEDIES. 



DIARRHCEA, CHRONIC. 

Alum, 208. 

Alum waters, 209. 

Astringent enemata, 376. 

Bismuth preparations, 206. 

Brandy, 216. 

Carbolic acid, 513. 

Catechu, 184. 

Copper sulphate, 198. 

Creosote, 517. 

Diet (see acute). 

Ferric nitrate solution, 435. 

Haematoxylon, 186. 

Kino, 185. 

Krameria, 185. 

Lead acetate, 194. 

Mineral astringents, 193 et al. 

Naphthalin, as intestinal antiseptic, 

534- 
Nutgall enemata, 183. 
Pepsin, 166. 
Port wine, 215. 
Salol, if stools be fetid, 532. 
Silver nitrate solution by enema, 203. 
Sodium phosphate in infantile, 347. 
Tannic acid, internally and by enema, 

181. 
White oak bark decoction, 187. 
Zinc sulphate, 199. 

DILATATION OF THE STOM- 
ACH. 

Gastric lavage, 31. 
Nutrient enemata, 377. 

DIPHTHERIA. 

Alcohol, 214; Antitoxine, see Appen- 
dix, 647. 

Borax, boric acid and potassium chlo- 
rate, irrigating solution, 507. 

Boric acid lotion, 506. 

Carbolic acid, with tinctura ferri chlo- 
idi in glycerin to throat, 514. 

Ferric chloride tincture (the best in- 
ternal remedy), 433. 

Hydrochloric acid, topically, 173. 

Hydrogen peroxide spray, 503. 

Lactic acid, topically, 176. 

Lime solution, atomized, 495. 

Papaya, topically, to dissolve mem- 
brane, 168. 

Potassium chlorate gargle, 481. 

Salicylic acid, topically, 530. 

Thymol gargle, 546. 

DROPSY (see also Ascites). 
Aspiration, 31. 

Bandages to promote absorption, 28. 
Basham's mixture, 434. 
Bryonia, 363. 
Caffeine in cardiac, 134. 
Chimaphila in cardiac, 418. 
Convallaria in cardiac, 285. 
Digitalis if due to heart disease, 280. 



DROPSY (continued). 
Elaterin, 372. 

Gamboge and cream of tartar, 371. 
Jalap, 361. 
Juniper, 398. 
Juniper seeds with bitartrate of potash, 

a very active diuretic, 398. 
Magnesium sulphate in concentrated 

solution, 344. 
Podophyllum, 365. 
Potassium acetate, 388. 
Potassium bitartrate, 348. 
Scoparius, 399. 
Sodium acetate, 388. 
Sparteine in cardiac, 284. 
Spiritus aetheris nitrosi as diuretic, 257. 
Squill and digitalis, 390. 

DUMB AGUE (see Malarial Ca- 
chexia). 

DYSENTERY, ACUTE. 

Brandy, 216. 

Camphor in initial stage, 129. 

Castor oil purge, 336. 

Diet (see Dietary in Appendix, and 

that of Acute Diarrhoea). 
Dover's powder in first stage, 92. 
Glycerin enema, 588. 
Hope's camphor mixture, 130. 
Hydrochloric acid, dilute, 173. 
Ipecacuanha, 326. 
Lead acetate, I94. 
Magnesium sulphate, 345. 
Naphthalin as intestinal antiseptic, 534, 
Opium in early stage, 88. 
Quinine enemata, warm, in tropical, 

161. 
Sodium and Potassium tartrarte, 348. 
Tannic acid, 181. 
DYSENTERY, CHRONIC. 
Alum waters, 209. 
Astringent enemata, 376. 
Brandy, 216. 
Catechu, 184. 
Copper sulphate, 198. 
Diet (see Dietary in Appendix and 

Acute Diarrhoea). 
Ferric ammonium sulphate, 436. 
Gallic acid, 182. 
Glycerin enemata, 588. 
Haematoxylon, 186. 
Kino, 185. 
Krameria, 185. 
Nutgall enemata, 183. 
Port wine, 215. 
Silver nitrate enema, 203. 
Tannic acid, 181. 
DYSMENORRHCEA. 
Acetanilid, 522. 
Apiol, 426. 
Belladonna and opium suppository, 

102. 



INDEX OF DISEASES AND REMEDIES. 



661 



DYSMENORRHEA (continued). 
Cannabis Indica, 1 12. 
Ergot in congestive, 274. 
Guaiac, 383. 
Hot water-bag to spine or abdomen, 

33- 

Sumbul, 321. 

Uterine examination necessary to de- 
termine cause, then appropriate 
remedy as correction of displace- 
ment ; the evacuation of clots by 
dilating cervix with tent (of slippery 
elm bark, 577), etc. 

Viburnum opulus, 320. 

Viburnum pruni folium, 319. 
DYSPEPSIA. 

Alcohol, 214. 

Aloes, 357. 

Ammonia, aromatic spirits of, 219. 

Apollinaris water, 572. 

Aromatics, if flatulent, 221 et al. 

Arsenic, 475. 

Auri et sodii chloridum in nervous 
cases, 458. 

Capon springs water, 490. 

Capsicum, 223. 

Cascarilla, 153. 

Change of air, habit and location. 

Charcoal, 597. 

Dermatol in fermentative, 549. 

Eucalyptus, 150. 

Eupatorium, 152. 

Ferrous sulphate, 431. 

Fowler's solution, 476. 

Gentian, 146. 

Homburg waters, 351. 

Hydrastis, in females with constipa- 
tion and leucorrhcea, 267. 

Hydrochloric acid, dilute, 173. 

Ipecac, 327. 

Kissengen water, 351. 

Lactic acid, 175. 

Leamington water, 352. 

Lime water and milk, 494. 

Magnesia, 493. 

Mercurial cholagogues, 442. 

Michigan Congress Spring, 349. 

Mineral acids, 170. 

Mineral waters, carbonated, 572 ; with 
milk, 572. 

Naphthalin as anti-fermentative, 533. 

Nitro-hydrochloric acid, dilute, 174. 

Ox gall, 167. 

Papaya, 167. 

Pepper, black, 223. 

Pepsin, 166. 

Phosphoric acid, dilute, 175. 

Potassium bichromate, 482. 

Potassium bicarbonate, or carbonate, 
486. 

Prepared chalk, 495. 

Quassia, 145. 



DYSPEPSIA (continued). 

Rhubarb, 355. 

Saratoga waters, 349. 

Sodium bicarbonate, 489. 

Strychnine, as tonic, 264. 

Strychnine and phosphoric acid, 265. 

Taraxacum, 397. 

Vichy water, 491. 

Zingiber, 227. 
DYSPNCEA, CARDIAC. 

Amyl nitrite, 312. 

Aspidosperma in functional, 322. 

Lobelia, 306. 

Morphia, hypodermically, to alleviate, 
90. 

Nitroglycerin, 314. 

Sparteine, 284. 

Strychnine, 264. 
EARACHE. 

Aconite in that from otitis media, 236. 

Cocaine, topically, 139. 

Hot water introduced to auditory canal 
to relieve pain, 33. 

Laudanum and olive oil, warm, applied 
within auditory canal, 92. 

Morphia, hypodermically, 88. 
ECLAMPSIA (see Puerperal Con- 
vulsions). 
ECTHYMA. 

Bismuth, iodoform and boric ointment, 
206. 

Lead, subacetate lotion, to antagonize 
inflammation, 194; then dress with 
bismuth and zinc oxide ointment, 
206, or iodoform, boric acid and bis- 
muth ointment, 206. 

Tepid alkaline bath, to soften crusts, 
34. 
ECZEMA, ACUTE. 

Alumnol, 549. 

Black wash, 448 ; with zinc oxide 
ointment, 449. 

Bismuth subnitrate ointment, 206. 

Bismuth oleate, 206. 

Boric acid dressing, 506. 

Camphor cream, 131. 

Carbolic and liq. potassas for pruritus, 

Cocaine, topically, for itching, 139. 

Dermatol, 549; Gallanol, 549. 

Gelsemium, internally, to relieve itch- 
ing, 317. 

Icthyol, 548. 

Lead subacetate lotion, 195. 

Menthol as antipruritic, 232. 

Poultices, if much infiltration with 
crusts, 569-570. 

Regulate bowels and digestive func- 
tions. 

Salicylic acid, topically, 530. 

Tar, 409. 



662 



INDEX OF DISEASES AND REMEDIES. 



ECZEMA, ACUTE (continued). 

Tar soap, 410. 

Tepid alkaline bath, 34. 

Thiol, 548. 

Zinc oleate, 200. 

Zinc oxide ointment, 199. 
ECZEMA, CHRONIC. 

Arkansas hot springs, 34. 

Arsenic, 474. 

Baths, natural hot, 34. 

Cade, oil of, 408-410. 

Calomel ointment, 451. 

Carbolic and liq. potassse for pruritus, 

514. 
Citrine ointment. 457. 
Corrosive sublimate ointment, 454. 
Creosote to relieve pruritus, 517. 
Diachylon ointment, 196. 
Fowler's solution, 476. 
Galvanism, 45. 
Green soap, 567. 
Hebra's ointment, 196. 
Hydrargyrum ammoniatum, 456. 
Icthyol, 548. 
Lanolin, 585. 
Leuk water, 496. 

Potassium iodide, if arsenic fail, 464. 
Poultice to detach crusts, 569-570. 
Resorcin ointment in squamous and 

seborrheal, 526. 
Sarsaparilla, 382. 
Silver nitrate, 204. 
Sulphur internally, 338. 
Sulphur waters, 340-I. 
Tar soap, 410. 

Tar and sulphur in scaly, 409. 
Thiol, 548. 
Zinc oleate, 200. 
Zinc phosphide, 179. 
EMPHYSEMA. 

Cod-liver oil, 468. 

Ferric chloride tincture, 433. 

Morphia, hypodermically, for asth?na 

of, 90. 
Strychnine to relieve dyspnoea, 264. 

EMPYEMA. 

Aspiration, 31. 

Bandages to promote absorption, 28. 

Iodine tincture injected into pleura, 
461. 

Morphine, hypodermically, for dysp- 
noea, 90. 

Quinine as tonic, 161. 

ENCEPHALOPATHY (see p. 193). 

ENDOCARDITIS. 

Aconite to control cardiac action, 238. 
Alkalies if of rheumatic origin, 484, 

et al ; or Fuller's alkaline treatment, 

487. 
Blisters to praecordium, 555. 



ENDOCARDITIS (continued). 

Ice-bag to praecordium to quiet heart,36. 

Salicylic acid, 529, or sodium salicy- 
late if rheumatic, 530. 
ENDOMETRITIS. 

Carbolic acid, 515. 

Hot bath, 34. 

Hot water injected within uterus, 33. 

Iodine tincture to uterus, 460. 

Leeches, early, 28. 

Nitric acid to uterus, 172. 

Sponge-tent, 598. 
ENTERALGIA (see Colic, Intestinal). 
ENTERITIS. 

Acacia, 573. 

Calomel, 450. 

Castor-oil purge, 336. 

Copper sulphate, 198. 

Diet : liquid, milk and beef-tea (see 
Dietary in Appendix). 

Opium or morphia, 89. 

Zinc sulphate, 199. 
EPIDIDYMITIS (see Orchitis). 
EPILEPSY. 

Acetamlid, 522. 

Acidum hydrobromicum dilutum, 302. 

Ammonium bromide, 301. 

Amyl nitrite, inhaled, to ward off seiz- 
ure, 312. 

Bromides, viz : calcum, sodium, stron- 
tium, lithium and zinc, 301. 

Creosote, 517. 

Ice-bag to spine, 36. 

Ice-bladder to spine, 35. 

Iron preparations, 429. 

Medicinal treatment often useless till 
exciting cause is determined, as 
dental or ocular defects, pressure 
upon cerebrum, etc. 

Potassium bromide the remedy, 299. 

Silver nitrate, 202. 

Sodium borate, if bromides are not 
borne, 507. ' 

Zinc oxide, 199. 

Zinc valerianate, 201. 

EPISTAXIS. 

Carbolized oil on cotton, 514. 
Cocaine, topically, 140. 
Cotton pledgets, 598. 
Monsel's solution, 432. 
Position upright, head thrown back. 
Sponge within nostril, 598. 
Tannin cotton tampon, 1 81. 
Vinegar on cotton tampon, 258. 

ERUCTATION (see also Acidity). 
Carbolic acid, 513. 
Charcoal as absorbent, 597. 
Creosote, 517. 

Liquor potassae, 485, or sodse, 488. 
Phosphoric acid, dilute, 175. 



INDEX OF DISEASES AND REMEDIES. 



663 



ERYSIPELAS. 

Aconite in medical, 240. 
Antipyrine, 537. 
Boric acid dressing, 506. 
Carbolic acid by injection. 
Ferric chloride tincture. 



513. 

very 



effica- 

t 



75- 



[99. 



cious, 433. 
Icthyol, 548. 

Iodine tincture, topically, 460-462. 
Iodoform in collodion, 542. 
Olive-oil inunction, 334. 
Quinine and iron the best remedies, 

160. 
Resorcin, 526. 
ERYTHEMA. 

Bismuth subnitrate ointment, 206. 
Camphor, topically, 130. 
Carbolic acid lotion, 514. 
Hydrochloric acid, dilute, topically, 

173. 

Icthyol, 548. 

Lactic acid, topically 

Silver nitrate, 562. 

Zinc oxide ointment, 
EXCORIATIONS. 

Court plaster, 595. 

Glyceritum amyli, 583. 

Goulard's cerate, 195. 

Liquor gutta-perchse, 593. 

Lycopodium, 596. 

Resin cerate, 594. 

Starch-powder, 583. 
EXHAUSTION. 

Alcohol to support the system, 214. 

Coca, 135. 

Hot bath, 33. 

Wine, 215 (see Appendix for list of). 
EXOPHTHALMIC GOITRE. 

Belladonna and ergot, 102. 

Digitalis, 281. 

Electricity, 43. 

Ice-bag to cardiac region to quiet 
palpitation, 36. 

Quinine, 161. 
FACIAL PALSY. 

Blisters to mastoid, 556. 

Galvanism, 42. 

Hot application to angle of jaw when 
due to cold, 33. 

Massage of facial muscles, 47. 
FAVUS (See also Dermatophyti in 
Appendix). 

Carbolic acid, 514. 

Chrysarobin, 568. 

Corrosive sublimate ointment, 454. 

Naphtol soap or pomade, 535. 

Poultices to remove crusts, 569, 570; 
then depilate hairs and apply para- 
siticides. 

Soap, wash parts with, 566. 

Sulphur ointment, 338. 

Tar and iodine, 409. 



FEET, FETOR OF. 

Boric acid solution, 506. 

Chromic acid, 563. 

Green soap, 567. 

Potassium permanganate lotion, 499. 

Talc, 596. 
FELON. 

Cocaine, topically, 139. 

Lead water, 194; Poultice, 570. 
FEVER. 

Aconite, 238-9. 

Antipyretics as, Acetanilid, 521 ; An- 
tipyrine, 537 ; Phenacetine, 539 '■> 
Phenol hydrochloride, 539. 

Apollinaris water, 572. 

Berberine, 148. 

Calomel, 450. 

Calumba, 147. 

Camphor, 130. 

Carbonated mineral waters, 572. 

Cocaine to sustain heart, 139 ; by Hy- 
podermic injection, 141. 

Cold bath, pack, or wet sheet, 36. 

Cold liquids and ice internally, 37. 

Cold sponging, 35 ; Digitalis, 280. 

Guaiacol, as topical antipyretic, 518. 

Hoffman's anodyne, 143. 

Ice-water, 572; Ice, cracked, 37. 

Liquor ammonii acetatis, 256. 

Liquor potassii citratis, 256. 

Mineral acids, 170. 

Mustard foot-bath, hot, 553. 

Nitre, sweet spirit of, 257. 

Opium to procure rest, 88. 

Potassium bitartrate, 348. 

Potassium citrate, 255, 256. 

Potassium nitrate, 255. 

Quinine, as antipyretic, 160. 

Seipentaria in later stage of, 148. 

Tartar emetic, 252. 

Vinegar sponging with, 258. 
FEVER, HECTIC (see Phthisis). 
FISSURE OF NIPPLES. 

Alum lotion, 208. 

Boracic acid ointment, 506; Glycerite 
of boroglycerin, 507. 

Collodion, 594. 

Deshler's salve, 594. 

Lead nitrate, topically, 195. 

Tannin ointment, 181. 
FISTULA. 

Carbolic acid dressing, 515. 

Iodoform, 541. 

Silver nitrate, 562. 
FLATULENCE. 

Alcohol, 214. 

Aromatics, 221, et al. 

Ginger, 227. 

Peppermint troches, 233. 

Purgative enemata, 375 ; or magne- 
sia, 343- 

Sodium bicarbonate, 489. 



664 



INDEX OF DISEASES AND REMEDIES. 



FLEA (see Appendix for Parasites, 

Remedies, etc.). 
FRACTURE. 

Adhesive plaster, 594. 

Bran in compound, 598. 

Carbolic dressing to compound, 515. 

Plaster of Paris bandage, 592. 

Silica bandage, 593. 
FRECKLES. 

Corrosive sublimate lotion, 454. 

Green soap, 567. 

Liquor potassse lotion, 485, followed 
by unguents, as cold cream, 189. 
FROST-BITE (see Chilblain). 
FUNGOUS GRANULATIONS. 

Lunar caustic, 204, 562. 
GALACTAFUGES. 

Belladonna ointment or plaster, or 
atropine, topically, 103. 

Magnesium sulphate, 344. 

Potassium iodide, 464. 
GALACTAGOGUES. 

Castor oil leaves, decoction of, to 
breasts, 337. 

Faradization, 45. 

Pilocarpus, 380. 
GALLSTONES (see Calculi, Biliary). 
GANGRENE. 

Alcohol to support the system, 214. 

Bromine, 565. 

Carbolic acid as cauterant, 514; as 
spray to Gangrene of Lungs, 514. 

Charcoal poultice, 571, 597. 

Mercuric nitrate, solution of, topically, 

457- 

Wine, 215 (see Appendix for list of). 

Zinc chloride, 565. 
GASTRIC ULCER (see Ulcer, 

Gastric). 
GASTRITIS, ACUTE. 

Bismuth subnitrate, 206. 

Calomel, 450. 

Carlsbad water, 352. 

Diet : Milk alone or with carbonated 
mineral waters, 572, 6io-li. 

Friedrickshall water, 352. 

Ipecac emetic, 327. 

Salicylic acid as antizymotic, 530. 

Vichy water, 491, 
GASTRITIS, CHRONIC. 

Bismuth subnitrate, 206. 

Charcoal, 597. 

Diet : Milk diet with sodic chloride, 
or carbonated waters, 57 2 > avoid 
sugars and starches, eat slowly and 
not too much. (See Dietary, Appen- 
dix). 

Gastric lavage, 3 1. 

Gentian, 146. 

Hydrochloric acid, dilute, 173. 



GASTRITIS, CHRONIC (continued). 
Nitro-hydrochloric acid, dilute, 174. 
Nutrient enemata, 377. 
Pancreatin, 1 67. 
Pepsin, 166. 
Quassia, 145. 

Resorcin as antifermentative, 526. 
Silver nitrate, 203. 
Strychnine as tonic, 264. 

GASTRO-INTESTINAL CA- 
TARRH (see also Gastritis, 
Chronic). 

Bismuth subnitrate, 206. 

Naphthalin, 533.I Intestinal Anti- 

Salol, 532. J septics. 

Sinapism to epigastrium, 552. 

GASTRODYNIA. 

Bismuth subnitrate, 206. 

Cannabis indica, as gastric sedative, 

112. 
Cocaine, 139. 
Codeine, 93. 
Ether, 116. 

Hoffmann's anodyne, 143. 
* Hydrocyanic acid, dilute, 309. 
Manganese dioxide, 169. 
Morphia, cocaine and belladonna 

combined, 89. 
Nitroglycerin, 314. 
Strontium bromide, 30I. 

GINGIVITIS. 

Boric acid mouth-wash, 506 ; with 

borax and potassium chlorate, 507. 
Carbolic acid mouth- wash, 515. 
Myrrh mouth-wash, 419. 

GLAUCOMA. 

Eserine, 292. 

GLEET. 

Alum and cubebs, internally, 208. 

Alum injection, 208. 

Catechu injection, 184. 

Copaiba, 411. 

Copper sulphate injection, I98. 

Corrosive sublimate injection, 454, 502. 

Hydrastine injection, 267. 

Mineral astringents, 191 to 209; often 
advantageously injected with deep 
urethral syringe. Surgical interfer- 
ence frequently necessary. 

Resorcin injection, 527. 

Silver nitrate injection, 204. 

Zinc acetate injection, 200. 

Zinc sulphate injection, 199. 

GOITRE. 

Iodine internally, 460; injection of the 
tincture, 461 (See Appendix for 
hypodermic injection of, 637)- 

Iodine ointment, 462. 

Potassium iodide, 463. 



INDEX OF DISEASES AND REMEDIES. 



665 



all in 
warm 
water. 



GONORRHOEA, FEMALE. 

Carbolic acid injection, 515. " 

Corrosive sublimate injection, 
454, S02. 

Hydrogen peroxide injec- 
tion, 503. 

Potassium permanganate in 
jection. 499. 

Warm water injection, 33. 

GONORRHOEA, MALE. 

Alum and cubeb internally, 208. 

Alum injection, 208. 

Barley water, 576. 

Boric acid injection, 506. 

Catechu injection, 184. 

Chapman's copaiba mixture, 412. 

Cocaine injection, 139. 

Copaiba, 411. 

Copper sulphate injection, 198. 

Corrosive sublimate injection, 454, 
502. 

Cubeb, 413. 

Erigeron oil, 395. 

Hot hip-bath to relieve strangury, 33. 

Hot water injection, 33. 

Hydrastine injection, 267. 

Hydrastis injection, 268. 

Hydrogen peroxide injection, 503. 

Iodoform injection, 542. 

Kino injection, 185. 

Lead acetate injection, 194. 

Linseed tea, 575. 

Liquor potassae, 485, or sodae to neu- 
tralize urine, 488. 

Potassium permanganate injection, 
499. 

Salol, copaiba, and pepsin, 532. 

Santal oil, 414. 

Silver nitrate injection, 204. 

Slippery elm infusion, 577. 

Tannin injection, 181. 

Zinc acetate injection, 200. 

Zinc sulphate injection, 199. 

Zinc sulphocarbolate injection, 516. 
GOUT. 

Arkansas hot springs, 34. 

Baths, natural hot, 34. 

Calcareous waters, 496. 

Caledonian Springs, 350. 

Capon spring water, 490. 

Carlsbad water, 352. 

Colchicum, 394. 

Contrexville water, 496. 

Diet, very important ; should consist of 
milk, eggs, fish, oysters, meats, fats, 
fresh green vegetables, a limited 
quantity of starches, saccharines 
and acid fruits; no alcoholics. 

Kissingen water, 351. 

Fuller's lotion, 488. 

Lartigue's gout-pills, 394. 



GOUT (continued). 

Linimentum saponis, I31. 

Lithium bromide, 301. 

Lithium preparations, 492. 

Lithium mineral waters, viz.; Ballston 
Spa, Buffalo Lithia, Londonderry 
Lithia and Saratoga (Pavilion 
Spring), 493. 

Morphia, hypodermically, to relieve 
pain, 90, 637. 

Piperazine, 649. 

Poland spring water, 490. 

Saccharin, 592. 

Saratoga waters, 349. 

Scudamore's draught, 394. 

Sodium arsenate, 477. 

St. Catherine's water, 349. 

Sulphur waters, 340-1. 

Vichy water, 491. 

Wiesbaden water, 352. 

Wildungen water, 496. 
GRANULAR LIDS (see Ophthal- 
mia). 
GRAVEL (see Calculi and Uric Acid 

Diathesis). 
GUMMATA, CEREBRAL. 

Potassium iodide, 463. 
HEMATEMESIS. 

Ergotine, hypodermically, 274, 636. 

Ferric nitrate solution, 435. 

Ice, cracked, and swallowed, 37. 

Mineral acids, 170. 

Monsel's solution, 432. 

Opium or morphia, 89. 
HEMATURIA. 

Ergot, 274. 

Gallic acid, 182. 

Hamamehs, 188. 

Ice-bag over kidneys. 36. 

Opium or morphia, %%. 
HEMOPTYSIS. 

Aconite, 238. 

Alum solution, atomized, 208, 

Ergot, 274. 

Hamamelis, 188. 

Magnesium sulphate to produce free 
purgation, 344. 

Monsel's solution, atomized, 432. 

Opium or morphia for cough of, 90. 

HEMORRHAGE, General Remedies 
to Control (see also the other 
Haemorrhages) . 

Alum, internally and topically, 208. 

Blood-letting, 26. 

Carbolic acid, 515. 

Catechu, 184. 

Copper sulphate, topically, 198. 

Creosote, 517. 

Ergot, 274, hypodermically, 636. 

Galvano-cautery, 46. 



m 



INDEX OF DISEASES AND REMEDIES. 



HEMORRHAGE (continued). 

Ice-water, locally, 35. 

Lead acetate, 194. 

MonseFs solution applied to capillary 
oozing, 432. 

Styptic collodion, 432, 596. 

Tannic acid, 181. 

Veratrum viride, as cardiac sedative, 
244. 
HEMORRHAGE, CEREBRAL 

1 see Apoplexy). 
HEMORRHAGE, INTESTINAL. 

Astringent enemata, 376. 

Ergot, 274; hypodermically, 636. 

Ferric nitrate solution, 435 

Ice-water enemata, 376. 

Krameria, 185. 

Mineral acids, 170. 

Monsel's solution, 432. 

Morphia, 89. 

Opium, 89. 
HEMORRHAGE, RECTAL. 

Astringent enemata, 376. 

Cold water injection, 37. 

Lead acetate, topically, 194. 

Lead and opium suppository, 194. 

Tannin, 181. 
HEMORRHAGE, UTERINE 
(Post-Partum). 

Cotton medicated tampon, 598. 

Defribinated blood, enema of, 79. 

Digitalis, 280. 

Electricity in post-partum, 45. 

Ergot, 274; hypodermically, 636. 

Ether, hypodermically, to induce re- 
action, 116. 

Gallic acid, 182. 

Hot water injected into uterus as styp- 
tic, 33. 

Hydrastinince hydrochloras, 267. 

Hydrastis, 267. 
HEMORRHAGE, VAGINAL. 

Cold water, vaginal injection of, 37. 
HEMORRHOIDS. 

Anodyne enemata, 377. 

Astringent enemata, 376. 

Carbolic acid injection, not altogether 
safe, 514. 

Castor oil as purgative, 336. 

Cocaine, topically, 139. 

Gallic acid and stramonium ointment 
with hot sitz bath, 183. 

Hamamelis, 188. 

Iodoform suppository, 541. 

Krameria ointment, 186. 

Nutgall ointment, 184. 

Opium and belladonna ointment, to 
relieve pain, 91, 104 

Stramonium, topically, 106. 

Sulphur as laxative, 33S. 

Sulphur waters, 340. 

Tannin and belladonna ointment, 181. 

White oak bark ointment, 187. 



HAIRS, SUPERFLUOUS, TO RE- 
MOVE. 

Electrolysis, 46. 
HAY FEVER. 

Antipyrine, 537. 

Camphor sniffed into nostrils, 130. 

Carbolic acid spray, 514. 

Cocaine to nasal mucous membrane, 
140. 

Grindelia, 321. 

Iodine vapor inhaled for coryza, 460. 

Quinine as tonic, 161. 
HEADACHE. 

Acetanilid, 522. 

Aconite in throbbing, 238. 

Ammonii valerianas in nervous, 132. 

Antipyrine, very efficient, 537. 

Caffeine, 134. 

Camphor spirit, 130. 

Chloroform spirit as stimulant, 123. 

Ether, topically, as anodyne, 1 1 6. 

Glasses to correct refraction-errors. 

Guarana, 141. 

Hydrobromic acid, dilute, in conges- 
tive, 302. 

Mustard and hot water to feet, 553. 

Phenacetine, 539. 

Quinine, 161. 

Sodium bicarbonate if due to acidity 
or flatulence, 489 ; with vegetable 
bitters,. 144-153, in dyspeptic cases 
before meals. 

Tea, cup of, 133. 

Valerian in nervous, 132. 
HEART, AORTIC CONSTRIC- 
TION AND REGURGITA- 
TION OF. 

Digitalis, if heart's action be feeble, 
or compensation broken, 280. 

Recumbent posture. 
HEARTBURN. 

Ammonia, aromatic spirit of, 493. 

Liquor potassee to neutralize gastric 
acidity, 4.85. 

Magnesia as antacid and laxative, 343, 

493- 
HEART, DILATATION OF. 

Cimicifuga, with languid circulation 
and oppressed breathing, 287. 

Digitalis, 280. 

Ferric chloride tincture, 433. 

Nitroglycerin to relieve dyspnoea, 314. 

Strychnine to relieve dyspnoea, 264. 
HEART, FATTY. 

Cimicifuga, 287. 

Digitalis, 280. 

Nitroglycerin to relieve dvspncea, 314. 
HEART, HYPERTROPHY OF. 

Aconite the best remedy, 240. 

Potassium bromide, 298. 

Recumbent posture. 

Veratrum viride, 244. 



INDEX OF DISEASES AND REMEDIES. 



667 



HEART, IRRITABLE. 

Digitalis, 280. 

Potassium bromide, 298. 

Sparteine, 284. 
HEART, MITRAL REGURGITA- 
TION OF. 

Adonidin, 282. 

Convallaria, 285. 

Digitalis, 280. 

Juniper as diuretic, 398. 

"Potassium bitartrate to remove dropsy, 
348. 

Sparteine, 284. 

Strophantus, 283. 
HEART, OVERACTING (see Hy- 
pertrophy). 
HEART, PALPITATION OF. 

Aconite, 240. 

Cocaine, 139. 

Potassium bromide, 298. 
HEMIPLEGIA. 

Cod liver oil, 468. 

Electricity, 42. 

Ferric chloride tincture, 433. 

Massage, 47. 

Strychnia, 263. 
HEPATITIS (see also Liver, Affec- 
tions of). 

Ammonium chloride in waxy infiltra- 
tion, 220. 

Capon Springs water, 490. 

Mercurial plaster over liver, 446. 

Michigan Congress Spring, 349. 

Nitro-hydrochloric acid, 174. 

Poland spring water, 490. 

Potassium iodide, in cirrhosis, 464. 
HERNIA. 

Enemata, forced, 375. 

Etherization for taxis, 119. 

Warm bath as relaxant, ^. 
HERPES. 

Arsenic for ' oral cankers,' 474. 

Black wash, 448. 

Calomel ointment, 451. 

Fowler's solution when persistent, 4 76. 

Zinc oxide ointment, 199. 
HERPES ZOSTER. 

Antipyrine for pains, 537. 

Belladonna ointment to relieve pain, 
104. 

Galvanism sometimes relieves the pain 
(see Chronic Eczema, p. 45.) 

Icthyol, 548. 

Peppermint oil as anodyne dressing, 

. 2 33- . 
Zinc oxide ointment, 199. 

HICCOUGH. 

Pilocarpine, 380. 
Potassium bromide, 298. 
Spirit of camphor, 130. 



HIVES (see Urticaria). 
HOARSENESS (see also Laryngitis 

and Pharyngitis). 
Barley sugar, 591. 
Borax lozenge, 507. 
Catechu troche, 184. 
Croton oil to skin over larynx, 374, 

561. 
Iodine tincture to skin over larynx, 

460. 
Linimentum ammonise, 554. 
Liquorice extract, 580. 
Potassium chlorate gargle or lozenge, 

481. 
Sinapism, 552. 
Sugar, 591. 
Wistar's lozenge, 92. 

HODGKIN'S DISEASE. 

Fowler's solution, 476. 

Phosphorus, 179. 
HORDEOLUM. 

Cotton, hot stupes of, 597. 
HYDROCELE. 

Adhesive plaster, rubber, 594. 

Aspiration, 31 ; Bandages, 28. 

Carbolic acid injection, 514. 

Iodine tincture injection, 461 (see 
Appendix, hypodermic solutions). 
HYDROCEPHALUS. 

Aspiration, 31. 

Potassium iodide, to promote absorp- 
tion, 464. 
HYDROPHOBIA (see Rabies.) 
HYDROTHORAX. 



Aspiration, 31. 
Colocynth, 370. 
Elaterin, 372. 
Jalap, 362. 



Hydragogue 
thartics. 



Juniper with potassium bitartrate, a 

very active diuretic, 398. 
Magnesium sulphate, concentrated, 

344- 
Scoparius, 399. 

HYPERIDROSIS. 

Belladonna tincture, topically, 103. 
Boric acid dressing, 506. 

HYPOCHONDRIASIS. 

Ferric chloride tincture, 433. 

Fowler's solution, 476. 

Moral treatment and change of scene 

are of first importance; medicines 

secondary. 
Valerian, 132. 
Zinc phosphide as nerve tonic, 179. 

HYSTERIA. 

Ammonium valerianate, 132. 
Asafcetida, 127. 

Chloral to calm excitement, 295. 
Cypripedium, 133. 



66S 



INDEX OF DISEASES AND REMEDIES. 



HYSTERIA (continued). 

Electricity, 44. 

Etherization, 119. 

Hoffman's anodyne, 143. 

Iron preparations, 429. 

Potassium bromide, 299. 

Sulphonal, 97. 

Sumbul, 321. 

Swedish movements, 48. 

Valerian, 132. 

Weir Mitchell treatment, 48. 
ICTERUS (see Jaundice). 
IMPETIGO. 

Bismuth, iodoform and boric acid oint- 
ment, 206. 

Citrine ointment, 457. 

Zinc oxide ointment, 199. 
IMPOTENCE. 

Alcohol in functional, 214. 

Auri et sodii chloridum, 458. 

Cantharis, 400. 

Electricity, when functional, 44. * 

Phosphorus in functional, 179. 

Strychnine, 264. 
INFLAMMATION. 

Aconite, 238. 

Antipyretics, as antifebrine, 521 ; an- 
tipyrine, 537 ; phenacetine, 539. 

Bandages to promote absorption of 
exudation, 28. 

Blood-letting, 26. 

Calomel, 450. 

Cups, 28; Compress, cold, 36. 

Digitalis, 280. 

Hot applications, to relieve, 33. 

Ice-water, locally, 35. 

Leeches in external, 28. 

Liquor plumbi subacetatis dilutus, 
topically, 195; with opium, 194. 

Magnesium sulphate, 344. 

Mercurials, 442. 

Potassium nitrate or nitrous powders, 

255. 
Poultices, 569-570. 
Tartar emetic, 251. 

Veratrum viride, to moderate vascu- 
lar excitement, 244. 
INFLUENZA. 
Antipyrine, 537. 
Camphor, 130. 
Eupatorium, 152. 

Guaiacol as topical antipyretic, 518. 
Iodine vapor inhaled for coryza, 460. 
Morphia, hypodermically, for head and 

back pains, 90, 637. 
Phenacetine, 539. 
Quinine as tonic, 161. 
INSANITY. 

Cold shower bath, 35. 
INSECTS, BITES OF (see Virus of 
Rabid Animals). 



INSOLATION (see Sunstroke). 
INSOMNIA. 

Alcohol, if due to cerebral anaemia, 

214. 
Chloral, 295. 
Chloralamide, if not due to pain or 

excitement, 98. 
Hydrobromic acid, dilute, 302. 
Opium, or morphia, 88. 
Paraldehyde, when not due to pain or 

mechanical causes, 95. 
Potassium bromide, 298. 
Sulphonal as hypnotic and calmative, 

97- 
INTERMITTENT FEVER (seealso 

Pernicious Malarial Fever). 
Aconite to moderate fever and pulse, 

240. 
Eucalyptus, 150. 
Morphia, hypodermically, to prevent 

paroxysm, 89, 637. 
Quinine, or its salts the remedy, 158. 
Serpentaria with quinine, 148. 
INTERTRIGO. 

Bismuth subnitrate and camphor 

powder, 206. 
Camphor, topically, 130. 
Lycopodium, 596. 
Zinc oxide ointment, 200. 
INTUSSUSCEPTION. 
Enemata, forced, 375. 
Opium or morphia, 89. 
Violent purgation to be avoided, 332. 
IRITIS. 

Atropine solution, (with 

mercury), 104. 
Daturine, 106. 
Duboisine, no. as mydri- 



atics. 



Homatropine, 104. 

Hyoscine hydrochlorate, ! 
100. J 

Cotton, hot stupes of, 597. 
ITCH (see Scabies). 
JAUNDICE. 

Calomel, in minute doses, continued. 

451. 
Capon Springs water, 490. 
Carlsbad water, 352. 
Diet: avoid fatty and saccharine foods ; 

milk and beef essence are suitable 

(see Dietary in Appendix). 
Diuretics to eliminate bile as potassium 

bitatrate and juniper berries, 398. 
Hydrastis in catarrhal, 267. 
Iris, 367. 

Nitro-hydrochloric acid, dilute, 174. 
Ox-gall, 167. 
Poland Spring water, 490. 
Potassium acetate as diuretic, 388. 
Sanguinaria in catarrhal, 329. 
Saratoga waters, 349. 
Sodium phosphate in catarrhal, 347. 
Vichy water, 491. 



INDEX OF DISEASES AND REMEDIES, 



669 



JOINTS, AFFECTIONS OF. 

Baths, natural hot, 34. 

Burgundy pitch plaster, 554. 

Camphor and chloral liniment, 1 30. 

Cod liver oil, 468. 

Etherization in breaking up adhesions 
and in dislocations, 1 19. 

Frictions, 29. 

Iodine tincture to thickenings and ex- 
udations about, 460. 

Mercuiial plaster to enlargements of, 
446. 

Potassium iodide, 463. 

Turpentine oil as counter-irritant, 407. 
KERATITIS. 

Atropine solution to eye, 104. 

Cod liver oil, 468. 

Cold water bathing to eyes for photo- 
phobia, 36. 

Cotton stupes, heated, 597. 

Duboisine, no. 

Eserine, 292. 

Leeches, 28. 

Potassium iodide, if syphilitic, 463. 

Poultice to orbit, 570. 

Yellow mercuric oxide ointment, 448. 
LABOR. 

A. C. E. mixture as anaesthetic, 123. 

Antipyrine in first stage to relieve 
pain, 537. 

Belladonna, topically, to relieve rigid 
os, 103. 

Castor oil as cathartic, 336. 

Chloral to relieve rigid os, 295. 

Chloroform by inhalation when os is 
completely dilated, 122. 

Confection of senna as cathartic, 359. 

Ergot in second stage, 273. 

Etherization during the pains of, 1 19. 

Quinine to promote uterine contrac- 
tion, 160. 

LARYNGISMUS STRIDULUS. 

Belladonna as antispasmodic, 102. 
Cold affusions, 36. 
Hot bath to ward off attack, 34. 
Potassium bromide, 298. 

LARYNGITIS. 

Aconite, given early, 239. 

Carbolic acid spray, 514. 

Croton oil to skin over larynx, 374, 

561. 
Iodine tincture to skin over larynx, 

460. 
Potassium chlorate lozenge or gargle, 

481. 
Silver nitrate, topically, 203. 
Sinapism, 552. 

Tannin gargle in chronic, 181. 
Tar water spray, 409. 
Tartar emetic in early stage, 251. 
"Wistar's lozenge, for cough, 91-2. 



As warm 
injections. 



LEAD PALSY, LEAD COLIC (see 
also Colica Pictonum). 
Strychnia, 263. 
Treatment of, 193. 

LEAD POISONING. 

Epsom salt and dilute sulphuric acid, 

344- 
Treatment of, 193. 

LEECH-BITES. 

Styptic collodion, 596. 

LEPRA. 

Arsenic, 474. 
Sulphur iodide, 466. 

LEUCORRHCEA. 

Alum injection, 208. 

Boric acid tampon, 506. 

Hydrastis, 267. 

Kino, 185. 

Krameria, 186. 

Lime water, 495. 

White oak bark decoc- 
tion, 187. 

Zinc acetate, 200. 

Zinc sulphate injection, 
very efficacious, 199. J 

LEUKEMIA. 

Fowler's solution, 476. 

Iron preparations as for ancemia, 428, 
etal. 
LICE (s ee Pediculosis and Appendix 

for Parasites). 
LICHEN. 

Arsenic, 474. 

Baths, natural hot, 34. 

Cold cream, 189. 

Leuk water, 496. 

Petrolatum, 590. 

Pix liquida and caustic potash to re- 
lieve itching, 409. 

Sulphur waters, 340— I. 

Tar, 409. 
LITH URIA (see Uric Acid Diathesis). 

LIVER, AFFECTIONS OF. 

Ammonium chloride, early, in cirr- 
hosis, 220. 

Aspiration to evacuate fluid in abscess 
of, 31. 

Blue mass in torpidity of, 445. 

Calomel in torpidity of, 450. 

Gray powder in torpidity of, 447. 

Homburg water in engorgement of, 

351- 

Nitro-muriatic acid in chronic hepati- 
tis, 174. 

Potassium iodide, early in, cirrhosis, 
464. 

Sulphur waters, 340-1. 
LOCKJAW (see Tetanus). 



670 



INDEX OF DISEASES AND REMEDIES. 



LOCOMOTOR ATAXIA. 

Acetanilid to relieve pain, 522. 

Antipyrine for pain, 537. 

Arsenic, 475. 

Calabar bean, 292. 

Electricity, 42. 

Exalgine to relieve pain, 523. 

Green iodide of mercury, if specific, 

455- 
Massage, 47. 
Nitroglycerin to relieve pain and 

tension of the vessels, 314. 
Potassium iodide, if specific, 464. 
Silver nitrate, 202. 

LUMBAGO. 

Acupuncture, 29. 

Antipyrine, 537. 

Atropine, hypodermically, 101, 636. 

Belladonna plaster, 103. 

Burgundy pitch plaster, 554. 

Blistering, in obstinate, 559. 

Camphor and chloral liniment, 130. 

Chloroform liniment, 123. 

Electricity, 42. 

Exalgine, 523. 

Frictions, 29. 

Linimentum saponis, 1 3 1. 

Massage, 47. 

Morphia, hypodermically, one of the 

best remedies, 89, 637. 
Warming plaster, 555. 

LUMBRICOIDES (see Worms). 
LUPUS. 

Acetic acid, glacial, 258. "] 

Aristol, 543. 

Arsenous acid, 475. 

Carbolic acid, 514. 

Caustic potassa, 563. 

Chloride of zinc, 200, 565. \ Topically 

Chromic acid, 564. 

Escharotics, 562, et al. 

Lactic acid, 176. 

Mercuric nitrate, solution | 

of, 457- • J 

Phosphorus, internally, 179. 

LYMPHADENOMA (see Hodg- 

kin's Disease). 
MALARIAL CACHEXIA. 

Arsenous acid, 474. 

Carbolic acid and iodine, 513. 

Quinine, the remedy, 159. 
MALINGERING. 

Etherization for diagnostic purpose, 
119. 

Faradization, 41. 
MANIA, ACUTE. 

Cannabis indica, 112. 

Chloral, 295. 

Conium, 289. 

Gelsemium, 317. 



MANIA, ACUTE (continued). 
Hyoscine hydrochlorate, 109. 
Hyoscyamine sulphate, to quiet the 

violence of, 108. 
Morphia, hypodermically, 88, 637. 
Opium, 88. 

Paraldehyde to procure sleep, 95. 
Potassium bromide, 298. 
Sulphonal as hypnotic and calmative, 

97- 
MANIA-A-POTU. 
Chloral, 295. 
Hops in mild cases, 114. 
Morphia, hypodermically, 88, 637. 
Opium, 88. 
Potassium bromide, 298. 

MASTURBATION. 

Avoid sedentary life and habits. 
Blistering glans penis, 560. 
Gelsemium as depresso-motor, 317. 
Potassium bromide as sedative to sex- 
ual organs, 300. 

MEASLES. 

Adeps, inunction with, 584. 
Antipyrine, 537. 
Fatty inunction, 584. 
Fever mixture, 143. 
Hoffman's anodyne, 143. 
Olive oil inunction, 334. 
Quinine, 160. 

MELANCHOLIA. 

Cannabis indica as cerebral stimu- 
lant, 112. 
Caffeine as cerebral stimulant, 134. 
Conium, 289. 
Fowler's solution, 476. 
Sulphonal as hypnotic, 97. 
Valerian, 132. 

MENINGITIS, CEREBRAL. 

Aconite, 239. 

Blister to nape of neck, 559. 

Cold compress or ice-bag to head, 36. 

Opium given hourly, 89. 

Potassium bromide to allay irritation, 

298. 
Purgatives (saline) at beginning, 343, 

et al. 

MENINGITIS, SPINAL (see also 
Meningitis, Cerebral and Cere- 
bro-Spinal Meningitis). 

Blister to nape of neck, 559. 

Ergotine, hypodermically, 274, 636. 

Potassium bromide, 298. 
MENOPAUSE. 

Cathartics as blue pill, 445 ; Hunyadi 
Janos water, 352, or Friedrickshall 
water, 352. 

Hydrastis, 267. 

Potassium bromide, 300. 



INDEX OF DISEASES AND REMEDIES. 



671 



MENORRHAGIA. (Is only a symp- 
tom and requiies careful exam- 
ination to ascertain cause). 

Cimicifuga, 287. 

Digitalis, 280. 

Nitric acid to uterus, 1 72. 

Potassium bromide, 300. 

Viburnum prunifolium, 319. 
MERCURIALISMUS. 

Alum gargle, 208. 

Atropine as anhydrotic, 102. 

Lime water mouth-wash, 495. 

Potassium iodide as eliminator, 464. 
METRITIS. 

Glycerin on cotton, 588 ; with Car- 
bolic acid, 588. 

Hot water injected into uterus, 33. 

Leeches, first stage, 28. 

Sponge-tent, 598; Warm bath, 34. 
MIGRAINE. 

Blue mass and a saline cathartic, 445. 

Caffeine as cerebral stimulant, 134. 

Cannabis Indica, 112. 

Electricity, 42-3. 

Guarana, very useful, 141. 

Ipecac, 327. 

Magnesia as antacid and laxative, 343, 

493- 

Phenacetine, 539. 

Potassium bromide, 299. 

Seidlitz powder, 348. 
MORPHIA-HABIT. 

Isolation, regular feeding and gradual 
withdrawal of drug, 91. 
MUCOUS PATCHES (see Condy- 
lomata). 
MUMPS. 

Cold compress over parotid gland, 36. 

Fever mixture, 143. 

Hoffman's anodyne, 143. 

Hot compress over parotid glands, 33. 

Pilocarpus, 380. 
MYALGIA. 

Atropine, hypodermically, very effica- 
cious, 101, 636. 

Antipyrine, 537. 

Belladonna liniment, 103. 

Burgundy pitch plaster, 554. 

Chloroform liniment, 123. 

Linimentum saponis with friction, 131. 

Morphia, hypodermically, very effica- 
cious, 89, 637. 

Salol, 532. 

Sinapisms, 552. 

Sodium salicylate, or salicylic acid, 530. 

Turpentine liniment, 408. 

Warming plaster, 555. 

MYELITIS. 

Ergotine, hypodermically, 274, 636. 
Cupping, 28 ; Ice-bag to spine, 36. 
Leeches, early, 28. 



MYRINGITIS. 

Boric acid, 506. 

Carbolic acid to disinfect auditory 

canal, 515. 
Cocaine, topically, 139. 
Leeches, early, 28. 
Scarification of membrana tympani, 

28. 

NjEVI. 

Monsel's solution, injected, 432. 
Nitric acid, 172. 
Potassa cum calce, 563. 

NARCOSIS. 

Alcohol, 214. 

Antidotes to opium, see p. 87. 

Apomorphine, 330, hypo., 636. 

Aqua ammoniae as stimulant, 218. 

Caffeine, 134. 

Cold affusions, to arouse in, 36. 

Copper sulphate emetic, 198. 

Electro-magnetic battery, as for that 
of opium, Sy. 

Mustard emetic, 55 2 « 

Potassium permanganate, against that 
of opium, 499. 

Zinc sulphate emetic, 199. 
NAUSEA. 

Ammonia, aromatic spirit of, 219. 

Apollinaris water, 572. 

Bismuth subnitrate, 206. 

Calomel, 450. 

Carbonic acid water, 572. 

Clysmic water, 572. 

Ice, cracked, swallowed, 37. 

Lime water, 494. 

Mineral waters, 572. 
NAUSEA MARINA (see Sea Sick- 
ness). 
NEURALGIA. 

Acetanilid, 522. 

Aconite, internally, 238. 

Aconite, topically, 240. 

Acupuncture, 29. 

Ammonii valerianas, 1 32. 

Antipyrine, 537. 

Arsenic, 474; with Quinine, 475. 

Baths, natural hot, 34. 

Belladonna, 101; liniment of with 
aconite, 103. 

Bismuth valerianate, 207. 

Blister in obstinate, 559. 

Cannabis Indica, occasionally, 112. 

Chloroform liniment, 122. 

Cocaine, topically, 139; Hypodermic- 
ally, 140, 636. 

Electricity, 42. 

Exalgine, 5 2 3- 

Gelsemium, 317. 

Iron preparations, in anaemic cases, 
429. 

Menthol, topically, 232. 



672 



INDEX OF DISEASES AND REMEDIES. 



NEURALGIA (Continued). 

Paraldehyde, occasionally useful, 95. 

Phenacetine, 539. 

Phosphorus, 179. 

Quinine, 160. 

Stramonium, 106. 

Veratrine ointment, 246. 

NEURASTHENIA. 
Alcohol, 214. 
Extract of malt, 216. 
Hydrocyanic acid, dilute, 309. 
Massage, 47. 
Phosphorus, 179. 
Potassium bromide, 299. 
Quinine, 160. 
Swedish movements, 48. 
Sulphonal as hypnotic, 97. 
Weir-Mitchell treatment, expensive, 
but results good, 48. 

NEURITIS (see Facial Palsy, Neu- 
ralgia, Paralysis and Sci- 
atica). 

NIGHTMARE. 

Potassium bromide, 298. 

NIGHT SWEATS. 

Atropine, hypodermically, 102, 636. 
Camphoric acid, 130. 
Picrotoxin, 269. 

Vinegar and water, sponging with, 
258. 

NYMPHOMANIA. 

Potassium bromide, 300. 

OBESITY. 

Caledonian Springs, 350. 

Capon Springs water, 490. 

Carlsbad water, 352. 

Diet: Avoid amylaceous, saccharine 
and fatty articles, alcohol and malt 
liquors. 

Exercise up to the point of free diapho- 
resis. 

Michigan Congress Spring, 349. 

Poland Spring water, 490. 

Potassium permanganate in dyspep- 
sia of, 498. 

Saccharin as substitute for sugar, 592. 

Saratoga water, 349. 

Vichy water, 491. 

OPACITY OF CORNEA (see Cor- 
nea). 
OPHTHALMIA (see also Conjunc- 
tivitis). 

Alum, topically, 208. 

Atropine solution to eye, 104. 

Cod liver oil, 468. 

Collodion to seal up sound eye, 595. 

Copper sulphate for granulations, 566. 

Corrosive sublimate collyrium, 454. 

Cotton stupes, heated, 597. 



OPHTHALMIA (continued). 
Iodoform, 542. 
Sassafras pith,. 5 7 7. 
Silver nitrate collyrium, 203. 
Yellow mercuric oxide ointment to 

remove granulatoins of, 448. 
Zinc acetate, 200. 

OPHTHALMIA, GONORRHCEAL 

(see also Ophthalmia). 
Atropine if perforation or iritic com- 
plications threaten, 104. 
Cold compress to orbit in first stage, 

37- 
Seal up sound eye with collodion, 595. 

Silver nitrate, topically, 203. 

Zinc acetate collyrium, 199. 

ORCHITIS. 

Belladonna ointment to scrotum, 103. 

Hops fomentation, 114. 

Lead acetate and opium lotion, 194. 

Lead subacetate lotion, 195. 

Oakum to support scrotum, 576. 

Rubber adhesive plaster to strap scro- 
tum after subsidence of inflamma- 
tion, 594. 

OTORRHEA. 

Aristol, 543. 1 

Bismuth subnitrate and | 

boric acid, 206. J- Topically. 

Boric acid, 506. 

Calomel, 45 1 . J 

Carbolic acid to disinfect canal, 515. 

Corrosive sublimate solution, instilla- 
tion of, 454. 

Cotton, 597. 

Dermatol, 549. 

Hydrogen peroxide to cleanse canal, 

503- 
Iodoform to canal, 542. 
Silver nitrate solution, 204. 
Zinc sulphate, 199. 

OXALURIA. 

Diet : avoid nitrogenous foods. 
Nitre-hydrochloric acid, dilute, 174. 

OZ^NA. 

Bromine by inhalation, 565. 

Carbolic acid spray, 515. 

Potassium chlorate solution, 481. 

Potassium permanganate douche, 499. 
PAINTER'S COLIC (see Colica Pic- 

tonum). 
PARALYSIS. 

Acupuncture, 29 

Arnica lotion, 247. 

Baths, natural hot, 34. 

Cold douche as excitant, 36. 

Galvanism, 42. 

Hot bath, 33. 

Massage, 47. 

Strychnia in functional, 263. 



INDEX OF DISEASES AND REMEDIES. 



673 



PARALYSIS AGITANS. 

Calabar bean as motor depressant, 292. 

Conium, 289. 

Electricity, 42. 

Gelsemium as motor depressant, 317. 

Is incurable. 

Strychnine, 263. 

Woorara, 318. 
PARAPLEGIA. 

Electricity, 42. 

Massage, 47. 

Potassium iodide, if syphilitic, 463, 
PARASITES, INTESTINAL (see 

Worms). 
PARONYCHIA. 

Lead water and opium, 1 94. 

Poultice, 570. 

Silver nitrate, 562. 
PEDICULOSIS (see also Appendix 
for Parasites, etc., of). 

Acetic acid to destroy nits of, 258. 

Chloroform lotion against P. pubis, 122. 

Corrosive sublimate lotion, 454; soap, 
502. 

Hydrargyrum ammoniatum, 456. 

Mercurial ointment, 446. 

Picrotoxin ointment or decoction, 269. 

Staphisagria, 249. 
PEMPHIGUS. 

Arsenic, 474. 

Diachylon ointment, 196. 

Fowler's solution, 476. 

Hebra's ointment (foot-note), 196. 

Puncture blebs. 

Zinc oxide ointment with starch, 199. 
PERICARDITIS. 

Aspiration, 31. 

Blister over heart during effusion, 559. 

Digitalis in^tage of effusion, 281. 

Ice-bag to praecordium before effusion, 

Leeches to praecordium; 28. 
Magnesium sulphate, concentrated, 

344- 
Quinine before effusion, 161. 

PERITONITIS. 

Aconite and opium, 239. 

Avoid active purgation, 337. 

Castor oil purge, 336. 

Diet: liquid, nourishing (see Dietary 
in Appendix) ; carbonated waters 
and milk, 572. 

Ice melted in mouth for thirst, 37. 

Opium or morphia, 89, 637. 

Poultice in early stage, 570. 

Purgative enemata, 371;. 
PERNICIOUS MALARIAL FE- 
VER. 

Quinine, internally or hypodermically, 
159 (for hypodermic solution of, see 
Appendix, 637). 
PERTUSSIS (see Whooping Cough). 
43 



PHAGEDENA. 
Bromine, 565. 
Nitric acid, 172. 

Potassium permanganate, topically, 
499. 
PHARYNGITIS (see also Hoarse- 
ness). 
Aconite given early, 239. 
Alum solution to throat, 208. 
Benzoic acid lozenge, 524. 
Borax, boric acid and potassium chlo- 
rate irrigating solution, 507. 
Cubeb lozenge, 413. 
Guaiac gargle, 383. 
Linimentum ammoniae, 554. 
Potassium chlorate gargle, 481; or 

lozenge, 481. 
Silver nitrate, topically, 203. 
Sodium benzoate gargle, 525. 
1 Sumach gargle, 190. 
Tannin gargle, 181 ; troches, 182. 
Tar water spray, 409. 
Tolu Balsam, inhalation of, 422. 
Wistar's lozenge for cough, 92. 

PHOSPHATIC DIATHESIS. 

Benzoic acid, 524. 

Mineral acids, 170-I-3. 
.Oak-orchard acid spring water, 171. 

Salol, to prevent urinary decomposi- 
tion, 532. 
PHOTOPHOBIA. 

Atropine solution to conjunctiva, 103. 

Cocaine, topically, 139. 

Cold water to eyes, 36. 

Eserine sulphate, 292. 

Homatropine, 104. 
PHTHIRIASIS. 

Arsenic, 474. 

Baths, natural hot, 34. 

Carbolic acid lotion, 514, preceded by 
shampooing with soap and water, 
566. 

Corrosive sublimate ointment, 454. 

Donovan's solution, 477. 

Green soap, 567. 

Hydrargyrum ammoniatum, 456. 

Leuk water, 496. 1 

Pilocarpine, 380. 

Potassa sulphurata ointment, 339. 

Resorcin ointment, 526 

Staphisagria, 249. 

Sulphur ointment, 338. 

Sulphur waters, 340—1. 

Tar oil, 409. 
PHTHISIS. 

Alcohol, 214. 

Atropine, for sweating of, 102. 

Atropine, strychnine and codeine to 
relieve cough of, 102. 

Camphoric acid for sweating of, 1 30. 

Carbolic acid spray, 514. 

Coca, 135. 



674 



INDEX OF DISEASES AND REMEDIES. 



PHTHISIS (continued). 

Cod liver oil, 468. 

Corrosive sublimate solution to disin- 
fect sputum, 501. 

Creosote, 517. 

Diet : nourishing and fat producing. 

Fatty inunction, 583. 

Guaiacol, 517-18. 

Hygienic measures; change to suitable 
climate. 

Iron preparations, 429. 

Lactic acid, topically, in laryngeal, 
176. 

Lead acetate against night-sweating, 
194. 

Lime lactophosphate, syrup of, 478. 

Malt liquors, 216. 

Pancreatin, 167. 

Picrotoxin, for night sweats of, 269. 

Prunus Virginiana, 165. 

Quinine in hectic fever, 160. 

Syrupus hypophosphitum, 479. 

Thymol inhalation, 545. 

PILES (see Haemorrhoids). 
PITTING (see Small-pox). 
PLEURITIS, ACUTE. 

Aconite before effusion, 239. 

Cocaine, hypodermically, to relieve 
pain, 140, 636. 

Fever mixture, 143. 

Iodine tincture to chest, 460. 

Magnesium sulphate to remove effu- 
sion, 344. 

Morphine, hypodermically, in first 
stage, 90, 637. 

Pilocarpus, 380. 

Poultice, 570. 

Salines, concentrated to remove dropsy, 
344- 
PLEURITIS, CHRONIC. 

Aspiration, 31. 

Bandages to prevent absorption, 28. 

Colocynth, 370. 

Elaterin, 372. 

Iodine tincture to chest, 460; injected 
into pleura, 461. 

Jalap, 362. 

Juniper and potassium bitartrate, an 
active diuretic, 398. 

Magnesium sulphate to remove effu- 
sion, 344; concentrated, 344. 

Pilocarpus, 380. 

Potassium acetate as diuretic, 388. 

PLEURODYNIA. 

Bandaging side, 28. 
Burgundy pitch plaster, 554. 
Morphia, hypodermically, 90, 637. 
Warming plaster, 555. 

PNEUMONIA. 

Aconite to control pulmonary conges- 
tion, 238-9. 



PNEUMONIA (continued). 

Alcohol to antagonize heart insuffi- 
ciency, 214. 

Ammonium carbonate, 221. 

Ammonium chloride, 220; iodide to 
promote absorption of exudation, 

465. 

Antipyrine, 537. 

Blood-letting, 26. 

Diet : beef tea, peptonized milk (see 
Dietary in Appendix). 

Dover's powder, early, as anodyne 
diaphoretic, 92. 

Eupatorium in later stage, 152. 

Grindelia, 321. 

Guaiacol as topical antipyretic, 518. 

Phenacetine, 539. 

Poultice, 570. 

Prunus Virginiana in later stage, 165. 

Quinine, 160. 

Resorcin, 526. 

Strychnine as cardiac tonic, 264. 

Veratrum viride before exudation, 244. 
POISONING. 

Stomach-pump to empty stomach, 31. 
POLYURIA (see Diabetes Insipi- 
dus). 
PORRIGO. 

Citrine ointment, 457. 

Corrosive sublimate ointment, 454. 

Picrotoxin ointment or decoction, 269. 

Red mercuric oxide ointment, 447. 

Silver nitrate, 204. 
POST PARTUM HEMORRHAGE 
(see Haemorrhage, Uterine). 

PREGNANCY. 

Avoid active purgation, 337. 

Castor oil, 336. 1 As laxatives. 

Confectio sennae. 359. j 
PREGNANCY, EXTRA UTERINE. 
Galvanism, 45. 

PRICKLY HEAT. 

Black wash, 448. 

Carbolic acid as antipruritic, 514. 

Infusum picis lia^idse, 409. 

Lead water, 194. 

Liquor potassae lotion, 485. 

Starch and Zinc oxide dusting powder, 

583- 
Tepid alkaline bath, 34. 
Tar soap, 410. 
Tarry preparations, 409. 

PROCTITIS. 

Astringent enemata, 376. 

Castor oil as purgative, 336. 

Emollient enemata, 376. 

Magnesium sulphate, 344. 

Opium and belladonna suppository, 91. 

PROLAPSUS ANI. 

Tannin enema, 181. 

White oak bark ointment, 187. 



INDEX OF DISEASES AND REMEDIES. 



675 



PROLAPSUS IRIDIS. 

Atropine solution to eye, 104. 
Duboisine, no. 
Homatropine, 104. 
PRURIGO AND PRURITUS. 

Borax lotion, 507. 

Cannabis indica, 112. 

Carbolic acid, 514; with liquor potas- 
sse, 514. 

Cocaine, topically, 139. 

Gelsemium, internally, to relieve itch- 
ing, 317. 

Hydrocyanic acid, topically, to allay 

Menthol, 232. [itching, 309. 

Naphtol soap or pomade, 535. 

Oleate of mercury, 448. 

Tarry preparations, 409-410. 
PRURITUS ANI. 

Carbolic acid, 514. 

Citrine ointment, 457. 

Cocaine, oleate of, 139. 
PRURITUS VULVE. 

Oleate of cocaine, 139. 

Peru balsam and acacia, 421. 
PRURITUS VAGINA. 

Hops infusion as injection, 114. 
PSORIASIS. 

Aristol, 543. Arsenic, 474. 

Arkansas hot springs, 34. 

Baths, natural hot, 34. 

Cade, oil of, 405, 410. 

Chrysarobin, 568. 

Citrine ointment, 457. 

Donovan's solution, 477. 

Fowler's solution, 476. 

Gallanol, 549. Green soap, 567. 

Hydrargyrum ammoniatum, 456. 

Lanolin, 585. 

Leuk water, 496. 

Phosphorus, 179. 

Pilocarpine, 380. 

Potassa sulphurata ointment, 339. 

Pyrogallol, 569. 

Soap, wash parts with, 566. 

Sulphur ointment, 338. 

Sulphur waters, 340-1. 

Tar, 409 ; Oil of, 408. 

Tar and sulphur, 409. 

Tepid alkaline bath, 34. 

Zinc phosphide, 179. 
PTYALISM (see Mercurialismus). 
PUERPERAL ECLAMPSIA. 

Amyl nitrite as antispasmodic, 312. 

Blood-letting, 27. 

Chloral, 295. 

Chloroform by inhalation, 122. 

Etherization, 119. 

Morphia or opium, 89, hypo., 637. 

Nitroglycerin, 314. 

Pilocarpus, 380. 

Potassium bromide, 299. 

Venesection, if plethoric, 27. 

Veratrum viride, 244. 



PUERPERAL FEVER. 

Antipyrine, 537. 
Iodoform uterine bougie, 542. 
Quinine, 160. 
Salicylic acid, 5 ^o. 
PUERPERAL SEPTICEMIA. 

Corrosive sublimate, vaginal injection, 

" 5°2, 

Opium, 89. 

Quinine as antipyretic with general 
treatment, 160. 
PULMONARY CONGESTION. 

Aconite in decided doses, 238. 
PURPURA. 

Ergot, 274. 

Mineral acids, 170. 

Turpentine oil, 407. 

Quinine, 161. 
PUSTULE. MALIGNANT. 

Escharotics, 562 et al. 

Iodine tincture, injected, 461, 637. 

Liquor hydrargyn nitratis, 565. 

Potassa, 563. 

Vienna paste, 563. 
PYEMIA. 

Alcohol, 213. 

Carbolic acid, topically, to check sup- 
. puration and thus prevent disease, 

Diet : sustaining (see Dietary in Ap- 
pendix). 
Ferric chloride tincture, 433. 
Quinine, 160. 

PYELONEPHRITIS. 

Benzoic acid, 524. ") 

Boric acid, 406, ! Urinary 

Naphthalin, 534; Salol, [Antiseptics. 

53 2 - J 

Milk diet (see Dietary in Appendix). 

Potassium acetate, 388 and other 
alkaline diuretics, well diluted. 

Turpentine oil, 407. 
PYROSIS (see also Gastritis, 
Chronic). 

Arsenic, 475. 

Bismuth preparations, 206. 

Carbolic acid, 513. 

Creosote, 517. 

Diet : skim milk (see Dietary in Ap- 
pendix). 

Lime solution, 495. 

Manganese dioxide, 168. 

Silver oxide, 205. 

RABIES. 

Carbolic acid to cauterize bite, 514. 

Chloral, 295. 

Chloroform by inhalation, 122. 

Cocaine to throat, 139. 

Liquor potassse as cauterant to bite, 

485. 
Opium, 88. 
Woorara, 318. 



676 



INDEX OF DISEASES AND REMEDIES. 



REMITTENT FEVER (see Inter- 
mittent Fever). 
RHEUMATISM, ACUTE. 

Aconite to joints, 240. 

Ammonium bromide, 301. 

Antipyrine, 537. 

Cold bath or wet sheet to moderate 
fever, 36. 

Cotton to joints, 597. 

Diet : milk and alkaline carbonated 
water, 572 ; beef tea in small quan- 
tities often given (see Dietary in 
Appendix). 

Dover's powder, as anodyne diapho- 
retic, 92. 

Fuller's alkaline treatment, 487. 

Fuller's lotion, 488. 

Gaultheria, oil of, 230. 

Laudanum poultice, 571. 

Menthol, topically, to relieve joint- 
pains, 232. 

Opium to relieve pain, 89. 

Potassium nitrate, 255. 

Potassium bicarbonate, 486. 

Salicin, 164. 

Salicylic acid, 529. 

Salipyrin, 538. 

Salix, 164. 

Salol, 532. 

Sodium salicylate, 530. 
RHEUMATIC ARTHRITIS. 

Arsenic, 475. 

Baths, natural hot, 34. 

Cod liver oil, 468. 

Croton oil, counter-irritation, 561. 

Ferric chloride tincture, 433. 

Frictions, 29. 

Guaiac, 383. 

Iodine tincture to joints, 460. 

Is incurable. 

Massage, 47. 

Sodium arsenate, 477. 

Warm and hot bath, 33. 
RHEUMATISM, CHRONIC. 

Acupuncture, 29. 

Ammonium chloride, 220. 

Arkansas hot springs, 34. 

Arsenic, 475. 

Baths, natural hot, 34. 

Bedford spring water, 490. 

Caledonian Springs, 350. 

Camphor liniment, 130. 

Carlsbad water, 352. 

Cod liver oil, 468. 

Cold douche to effect local excitation, 

3 6 - 
Cold compress to joints, 36. 
Croton oil, counter-irritation with, 561 . 
Electricity, 42-3. 
Frictions, 29. 

Galvano-cautery as counter-irritant, 46. 
Guaiac, 383. 
Hot air bath, 34. 



RHEUMATISM (Continued). 
Hot bath, 33. 

Iodine tincture to joints, 460. 
Linimentum saponis, 131. 
Lithian mineral waters, 493. 
Massage, 47. 

Phytolacca in syphilitic, 248. 
Poland spring water, 490. 
Potassium iodide, 464. 
Salicylic acid or sodium or lithium 

salicylate, 530. 
Salipyrin, 538. 
Sarsaparilla, 382. 
Sodium sulphate, 347. 
St. Catharine's water, 349. 
Sulphur waters, 340-1. 
Turpentine oil as counter-irritant, 407, 

554. 
Warm bath, 33. 
Weisbaden water, 352. 
Wintering in the south to avoid cold, 

damp weather. 
Veratrine ointment, 246. 

RHEUMATISM,GONORRHCEAL. 

Belladonna liniment, 103. 
Blisters, small, to parts, early, 555. 
Galvano-cautery as counter-irritant, 46. 
Laudanum poultice, 571. 
Massage, 47. 
Potassium iodide, 464. 
Salicylic acid, 529; or Sodium sali- 
cylate, 530. 
Treat the gonorrhoea, 41 1. 

RHEUMATISM, MUSCULAR (see 
Myalgia and Chronic Rheuma- 
tism). 

RICKETS. 

Cod liver oil, 468. 
Ferrous iodide syrup, 434. 
Phosphoric acid, dilute, 175. 
Phosphorus, 179. 
Prepared chalk, 495. 
Sodium phosphate, 346. 
RINGWORM (see Tinea). 

ROSEOLA. 

Ordinarily no treatment required. 
Petrolatum inunction, "1 r~ „n av 

„.59 • l cutaneous 

Zinc oxide ointment to [ irrhation# 
the eruption of, 200. J 

ROUND WORMS (see Worms). 

RUBELLA 

RUBEOLA 

RUPIA. 

Bismuth, iodoform and boric acid 

ointment, 206. 
Citrine ointment, 457. 
Peppermint oil as dressing, 232. 
Syphilitic treatment, the mercurials, 

442, et a/., or Potassium iodide, 463. 



(see Measles). 



INDEX OF DISEASES AND REMEDIES. 



677 



SALIVATION (see Mercurialismus). 
SARCINA VENTRICULI (see also 
Gastritis, Chronic). 

Carbolic acid, 513. 

Sulphurous acid, 504. 
SCABIES (See Appendix for Para- 
site, etc., of). 

Benzin, 519. 

Carbolic acid, 514. 

Naphtol soap or pomade, 535. 

Peru balsam and sulphur, 421. 

Phytolacca ointment, 248. 

Soap, wash parts with, 566. 

Staphisagria, 249. 

Sulphur ointment, 338. 
SCALDS (see Burns). 
SCARLET FEVER. 

Acetanilid, 522. 

Aconite, 240. 

Adeps, inunction with, 584. 

Antipyrine, 537. 

Cold bath or wet sheet, to moderate 
high fever, 36. 

Fatty inunction, 584. 

Glyceritum amyli to eruption, 583. 

Olive-oil inunction, 334. 

Petrolatum inunction, 590. 

Potassium chlorate gargle for sore 
throat, 481. 

Quinine, 160. 
SCIATICA. 

Atropine, hypodermically, ioi, 636. 

Blistering in obstinate, 559. 

Chloroform by deep injection, 122. 

Electricity, 43. 

Ether, hypodermically, 116. 

Exalgine, 523. 

Frictions, 29. 

Massage, 47. 

Quinine, 160. 

Rest in bed with leg in splint. 
SCLEROSIS, SPINAL (see also 
Locomotor Ataxia). 

Fowler's solution, 476. 

Potassium iodide, 464. 

Silver nitrate, 203. 
SCROFULA. 

Auri et sodii chloridum, 458. 

Caledonian springs, 350. 

Cod-liver oil, 468. 

Ferrous iodide syrup, 434. 

Hydriodic acid, syrup of, 466. 

Iodine internally for glandular enlarge- 
ments, 460 ; tincture of, topically to 
same, 460, or ointment, 462. 

Iron preparations, 429. 

Phosphoric acid, dilute, 175. 

Potassium iodide, 46 \ . 

St. Catherine's water, 349. 

Sulphur iodide, 466. 

Syrupus calcii lactophosphatis, 478. 

Yellow mercurous iodide, 455. 



SCURVY. 

Green vegetable diet. 

Lemon juice the prophylactic remedy, 

259- 
Mineral acids, 170. 

SEA SICKNESS. 

Amyl nitrite 312. 

Apollinaris water, 572. 

Carbonic acid water, 572. 

Chloral, 295. 

Mineral waters, carbonated, 572. 

Nitroglycerin to arrest vomiting, 314. 

Potassium bromide, 299. 

Rest in berth. 

SEPTICEMIA (see Pyaemia). 
SHOCK. 

Alcohol to support the system, 213. 
Ammonia, preparations of, 218-19. 
Cocaine injection to revive heart, 141. 
Opium, 88. 
Quinine in surgical, 160. 

SINGULTUS (see Hiccough). 
SMALLPOX. 

Alcohol to support the system, 213. 

Diet : nourishing (see Dietary in Ap- 
pendix). 

Morphia, hypodermically, for insomnia 
and back-pain, 90, 637. 

Quinine as antipyretic, 160. 
SMALLPOX, PITTING OF, TO 
PREVENT. 

Cold cream, 189. 

Glycerin, 588. 

Glyceritum amyli, 583. 

Menthol, 232. 

Petrolatum inunction, 590. 

Protection from light, 32. 

SNEEZING, OBSTINATE. 

Iodine vapor, inhalation of, 460. 
SORDES. 

Lime water, 495. "] 

Myrrh and carbolic acid, j 

4I9 : \ 

Potassium permanganate, j 

499- J 

SPERMATORRHOEA. 

Bandage of rubber applied around 
penis and scrotum to prevent erec- 
tion. 

Belladonna suppository to allay pros- 
tatic hyperesthesia, 103. 

Blister to perineum, 559. 

Cold metal bougie to relieve urethral 
hyperaesthesia. 

Conium to moderate irritability of 
sexual organs, 289. 

Electricity, 44. 

Gelsemium as depresso-motor, 3 1 7. 

Hygienic measures : exercise in open 
air; avoidance of sensual thoughts. 



Mouth 
washes. 



678 



INDEX OF DISEASES AND REMEDIES. 



SPERMATORRHEA (Continued). 

Potassium bromide, 300. 

Silver nitrate injection, to obtund 
urethral hyperesthesia, 204; cauter- 
ization with lunar caustic as last 
resort, 204. 

Strychnine, 264. 

SPINAL IRRITATION. 

Aconitine, topically, 241. 

Actual cautery, 34. 

Atropine, hypodermically, 102, 636. 

Ice-bag to spine, 36. 

Massage, 47. 

Veratrine ointment, 246. 

Weir-Mitchell treatment, 48, 

SPRAINS. 

Arnica, 247. 

Camphor and chloral liniment, 130. 

Cold compress, 36. 

Lead water and opium, with rest, 194. 

Linimentum saponis, 13 1. 

Plaster of Paris bandage, 592. 

Silica bandage, 593. 

STEARRHCEA. 

Linimentum saponis, 131. 

STIFF NECK (see Torticollis). 

STOMATITIS, GANGRENOUS 
(see Cancrum Oris). 

STOMATITIS, PARASITIC (see 
Aphthae, and Dermatophyti in 
Appendix, Thrush, 639). 

STOMATITIS, SIMPLE. 

Catechu troche, 184. 
Ice, cracked, and sucked, 37. 
Myrrh and carbolic mouth-wash, 419. 
Potassium chlorate solution mouth- 
wash, 481. 
Slippery elm infusion, 577. 
Thymol, 546. 

STOMATITIS, ULCERATIVE. 

Potassium chlorate solution mouth- 
wash, 481. 

Thymol mouth- wash, 546. 
STRANGURY. 

Alkaline waters freely taken to dilute 
the urine, 489, 491. 

Barley water, 576. 

Bath, hot hip, 33. 

Belladonna suppository, 103. 

Diet : milk and farinaceous foods (see 
Dietary in Appendix). 

Linseed tea, 575. 

Liquor potassae, 485, or sodae, 488. 

Opium and belladonna suppository, 91. 

Vichy water, 491. 
STYE (see Hordeolum). 
SUNSTROKE. 

Antipyrine, 537. 

Cold bath or wet sheet, 36. 

Morphia, hypodermically, 90, 637. 



SUPPURATION. 

Alcohol, 214. 

Antiseptics described on pages 496- 

.549- 
Lint, oakum and charpie, 576. 
Sulphides, 505. 
Wine, 215 (for list of, see Appendix). 

SWEATING. 

Atropia, 102. 

Camphoric acid, 130. 

Mineral acids, 170-1. 

Picrotoxin, 269. 

Vinegar, sponging skin with, 258. 

SYCOSIS (see also Dermatophyti in 

Appendix). 
Diachylon ointment in non-parasitic, 

196. 
Poultice, 570. 

Resorcin ointment, in parasitic ', 196. 
Soap, wash parts with, 566. 
Sulphur ointment, 338. 
Zinc oxide ointment, 199. 

SYNCOPE. 

Alcohol, 213. 

Ammonia water, 218. 

Amyl nitrite, 312. 

Belladonna as cardiac stimulant, 102. 

Brandy, 216. 

Cold affusions to arouse from, 36. 

Digitalis tincture, hypodermically, 280. 

Ether as stimulant, 116. 

Smelling salt, 221. 

SYNOVITIS. 

Aspiration, 31. 
Blisters, 555. 

Carbolic acid injection, 513, 636. 
Cold compress in early stage, 36. 
Iodine tincture to parts, 460. 
Laudanum poultice, 571. 
Lead acetate and opium lotion to allay 
pain, 194. 

SYPHILIS. 

Ammonium, potassium and sodium 

iodides combined, 464 ; separate, 

465. 
Arkansas hot springs, 34. 
Baths, natural hot, 34. 
Blue mass, 445. 

Calomel, 450; by fumigation, 451. 
Cod liver oil, 468. 
Corrosive sublimate internally and by 

injection, 453 ; hypodermic solutions 

of, see Appendix, 637. 
Corrosive sublimate with potassium 

iodide, 453. 
Donovan's solution, 477. 
Fumigation with mercury, 443~45i. 
Gray powder, 447. 
Green iodide of mercury, 455. 



INDEX OF DISEASES AND REMEDIES. 



679 



SYPHILIS (continued). 

Hypodermic injection of mercury, 443, 
453, and Appendix, 637. 

Inunction of mercury, 443, 446, 448. 

Mercurial preparations, general state- 
ment regarding, 442 ; forms of exhi- 
bition, 443, 444. 

Mercurial ointment by inunction, 446. 

Mercuric eyanide, 455. 

Oleate of mercury, by inunction, 448. 

Potassium iodide, 463-4. 

Red iodide of mercury, 455. 

Sarsaparilla, 382. 

Strontium iodide, 465. 

Sulphur water for eruptions of, 340-1. 

SYPHILIS, CONGENITAL. 

Gilbert's syrup, 465. 

Gray powder, 447. 

Mercurial ointment by inunction, 446. 

Oleate of mercury, 448. 
TABES DORSALIS (see Locomo- 
tor Ataxia). 
T^NIA (see Worms). 

TETANUS. 

Calabar bean, 292. 

Chloral to relieve reflex irritability, 295. 

Chloroform by inhalation, 122. 

Etherization to control spasms, 119. 

Ice bag to spine, 36. 

Opium to control spasms, 88 ; or mor- 
phine hypodermically, 88, 637. 

Potassium bromide, 299. 

Woorara, 318. 
THREAD WORMS (see Worms). 
THROMBOSIS. 

Ammonium carbonate to disolve clot, 
221. 

THRUSH (see Stomatitis, Parasitic). 
TIC DOULOUREUX (see Neu- 
ralgia). 
TINEA CAPITIS (see also Parasites 
in Appendix). 
Aqua chlori, 500. 
Benzin, 519. 

Blisters as cantharidal collodion, 560, 
before application of parasiticides in 
severe cases. 
Carbolic acid, 514. 
Chrysarobin, 568. 
Copper oleate, 198. 
Corrosive sublimate ointment, 454; and 
in comp. tinct. of benzoin, 454; in 
soap, 502. 
Hydrargyrum Ammoniatum, 456. 
Iodine tincture, 462. 
Oleate of mercury, 448. 
Picrotoxin ointment or decoction, 269. 
Sulphur ointment, 338 ; iodide, 466. 
Tar, 408. 
Thymol, 546. 



TINEA CIRCINATA (see also Par- 
asites in appendix). 

Aqua chlori, 500. 

Blistering parts, 560. 

Benzin, 519. 

Benzoin tincture as vehicle, 420. 

Carbolic acic, 514. 

Chrysarobin, 568, preceded by sapo 
viridis, 567, and retained by liquor 
gutta-perchse, 593, or rubber adhe- 
sive plaster, 594. 

Copper oleate, 198. 

Corrosive sublimate ointment, 454; 
in comp. tinct. of benzoin, 454; as 
soap, 502. 

Croton oil, 374. 

Green soap, 567. 

Hydrargyrum ammoniatum, 456. 

Iodine tincture, 462. 

Liquor gutta-perchse to retain parasiti- 
cides, 593. 

Naphtol, topically, 535. 

Salicylic acid ointment, 530. 

Sulphur ointment, 338. 

Sulphurous acid, 504. 

Tar and iodine, 409. 

TINEA TONSURANS (see Para- 
sites in Appendix). 
Blistering parts, 560. 
Carbolic acid, 514. 
Chrysarobin, 568. 
Corrosive sublimate soap, 502. 
Hydrargyrum ammoniatum, 456. 
Oleate of mercury, 448. 
Salicylic acid ointment, 530. 

TINEA VERSICOLOR (see also T. 
Circinata, and Parasites in Ap- 
pendix). 

Aqua chlori. 500. 

Benzin, 519. 

Carbolic acid, 514. 

Chrysarobin, 568. 

Copper oleate, 198. 

Corrosive sublimate ointment, 454 ; 

soap, 502. 
Green soap, 567. 
Iodine tincture, 462. 
Naphtol, topically, 535. 
Salicylic acid ointment, 530. 
Sodium hyposulphite solution, 504. 
Sulphur ointment, 338. 
Sulphurous acid, 504. 

TONSILLITIS, ACUTE. 

Aconite given early, 239. 

Alum, topically, 208. 

Guaiac, 383. 

Ice-bag to nape of neck, 36. 

Iodine tincture injected into hyper- 
trophied, 461 ; (see Appendix for 
hypodermic injection of, 637). 



680 



INDEX OF DISEASES AND REMEDIES. 



TONSILLITIS (continued). 

Potassium chlorate gargle or troches, 
481. 

Scarifications, 28. 

Silver nitrate solution, topically, 203. 

Sodium salicylate, 530. 
TOOTHACHE. 

Arsenic and creosote to cavity of car- 
ious tooth, 475. 

Carbolic acid, 515. 

Creosote, 517. 

Laudanum, topically, 92. 

Oil of cajuput, 226. 

Oil of cloves, creosote and chloro- 
form, 226. 

Tincture of iodine and aconite to gums, 
461. 
TORTICOLLIS. 

Atropine, hypodermically, 102, 636. 

Galvanism, 42. 

Morphia, hypodermically, 89, 637. 

Sinapism to neck, 552. 
TRACHOMA(seealso Conjunctivitis). 

Alum solution, 208. "1 

Copper sulphate, j 

topically, 198. \ To granulations. 

Silver nitrate, 204. 

Iodol, 545. 
TRICHINA SPIRALIS (see Para- 
site in Appendix). 

Active purges as jalap, 361, or scam- 
mony, 368 ; may cause expulsion 
from intestines before sexual ma- 
turity is accomplished and migra- 
tion begun, otherwise medicines are 
of little avail 
TUBERCULOSIS (see Phthisis). 
TYLOSIS. 

Lactic acid, 175. ) T ' 1 

Resorcin lotion, 526. \ " v . 

c v v -j k„~ applications. 

Salicylic acid, 530. J 1 r 

TYMPANITES. 

Asafoetida enema, 127. 
Turpentine oil, 407. 

TYPHLITIS. 

Avoid active purgation, 337. 

Diet : Beef tea and milk (see Dietary 
in Appknndix). 

Enemata of oil and warm water to dis- 
lodge fecal accumulations, 375. 

Ice-bag to iliac region at onset, 36. 

Opium or morphia to check peristalsis 
and relieve pain, 89. 

Poultice in early stage, 570. 

TYPHOID FEVER. 

Alcohql to support the system, 214. 

Acetanilid, 522. 

Antipyrine, 537. 

Asafoetida enema for tympanites, 127. 



TYPHOID FEVER (continued). 

Calx chlorata (4 per cent, solution) for 
excreta, 500; in powder for cess- 
pools, 500. 

Carbolic acid, crude, for excreta (i to 

20), 515- 
Castor-oil purge, 336. 
Charcoal to relieve meteorism, 597. 
Cold bath or wet sheet, 36. 
Corrosive sublimate solution, I to 500, 

for excreta, 501. 
Diet of first importance: Beef tea, 

beef-essence or milk (see Dietary 

in Appendix). 
Guaiacol as topical antipyretic, 518. 
Lead acetate and opium against 

haemorrhage of, 194. 
Mineral acids, 1 70-1-3. 
Naphtol as intestinal antiseptic, 535. 
Opium for peritonitis or morphia, hy- 
podermically, 89, 637. 
Phenacetine, 539. 
Potassium permanganate to disinfect 

stools, 499 (often mixed with equal 

parts of calx chlorata). 
Quinine as antipyretic, 160. 
Sulphurous acid as disinfectant, 503-4. 
Resorcin, 526. 

Turpentine oil for tympanites, 407. 
Wine, 215 (see Appendix for list of). 
Zinc chloride solution, I to 10, for 

excreta, 200. 

TYPHUS FEVER (see also Typhoid 
Fever). 
Alcohol to support the system, 214. 
Ether as stimulant, 116. 
Mineral acids, 1 70-1-3. 
Turpentine oil as stimulant, 407. 
Wine, 215. 

ULCER. 

Aristol, 543. 

Bismuth, iodoform and boric acid 
ointment, 206. 

Boric acid dressing, 506. 

Carbolic acid dressing, 515. 

Charcoal in sloughing. 597. 

Cocaine, topically, 139. 

Collodium, 595. 

Copper sulphate, 198; to remove gran- 
ulations, 566. 

Corrosive sublimate lotion, 454 ; dress- 
ing, 502 ; gauze, lint, cotton, etc., 
5oi. 

Dermatol, 549. 

Hydrogen peroxide dressing, 503. 

Hyoscyamus, topically, as anodyne, 
108. 

Iodoform, 541, 542. 

Iodol, 545- 

Kino, topically, 185. 

Peppermint oil as dressing, 232. 



INDEX OF DISEASES AND REMEDIES. 



681 



ULCER (continued). 

Poultice, 570; charcoal, 571 ; yeast, 

571. 
Rectal, astringent enemata, 376. 
Silver nitrate, 204 ; to granulations 

of, 562. 
Stramonium, topically, 106. 
Zinc chloride, 565. 

ULCER OF CORNEA. 

Atropine solution, 104. 
Iodoform, 541. 
Iodol,545. 

ULCER, GASTRIC. 

Arsenic, 475. 

Bismuth subnitrate to check vomiting, 
206. 

Diet: milk, gruel, beef tea, peptonized 
milk (see Dietary in Appendix). 

Fowler's solution, 476. 

Gastric lavage, 31. 

Nutrient enemata, 377. 

Silver nitrate, 203. 
ULCER, RODENT. 

Nitric acid, 172. 

Potassa, 563. 

Potassa cum calce, 563. 
URAEMIA. 

Amyl nitrite to relieve asthma of, 312. 

Chloral, for convulsions of, 295. 

Cups, wet or dry, to loins, 28. 

Iron and quinine citrate, 436. 

Taborandi, 380. 

Jalap, 362. 

Juniper with potassium bitartrate, 398. 

Nitroglycerin, to relieve asthma of, 

Opium for convulsions, 89. 
Potassium bromide, to relieve convul- 
sions, 299. 
Scammony, in coma of, 363. 
Scoparius, 399. 
Venesection, 27. 
URETHRITIS. 
Buchu, 416. 
Potassium permanganate injection, 

499- 
See also management of inflammatory 

symptoms, p. 411, in gonorrhoea. 
Zinc acetate injection, 200. 
Zinc sulphate injection, 199. 
URIC ACID DIATHESIS. 
Bedford Springs water, 490. 
Capon Springs water, 490. 
Carlsbad water, 352. 
Clysmic water, 572. 
Diet : red meats in moderation ; avoid 

pies, pastry, sweets, sugar and 

fruits, alcoholics and sweet wines. 
Contrexville water, 496. 
Liquor potassas, 485. 
Lithian mineral waters, 493. 
Mineral waters, carbonated, 572. 



URIC ACID DIATHESIS (cont'd). 
Piperazine as solvent of uric acid (see 

Appendix, 649). 

Poland Spring water, 490. 

Potassium bicarbonate or carbonate, 
486 ; citrate, 255. 

Potassium or sodium acetate to neu- 
tralize urine, 388. 

Sodium and potassium tartrate, 348. 

Vichy water, 491. 

"Wiesbaden water, 352. 

Wildungen water, 496. 

URINE, AMMONIACAL. 

Ammonium benzoate, 525. 

Benzoic acid, 524. 

Naphthalin, 534. 

Zea, 399. 
URINE, INCONTINENCE OF. 

Ammonium benzoate, 525. 

Belladonna tincture, 102. 

Catheter. 

Electricity, 44. 

Strychnine, 264. 
URINE, RETENTION OF. 

Catheterization the best remedy. 

Hot bath and opium, 34. 
URTICARIA. 

Carbolized glycerin, 514. 

Friedrickshall water, 352. 

Hunyadi Janos water, 352. 

Hydrocyanic acid, topically, 309. 

Hydrochloric acid, dilute, 173. 

Lactic acid, dilute, topically, 175. 

Vinegar lotion, 258. 
UTERINE FIBROMA. 

Ergot, 274. 

Galvanism, 45. 
VAGINISMUS. 

Cocaine, topically, 139. 
VAGINITIS. 

Boric acid tampon, 506. 

Hops infusion as injection, 1 14. 
VARICELLA. 

Carbolic ointment or lotion to erup- 
tion, 514. 
VARIOLA (see Small Pox). 
VERMES (see Worms). 
VERRUCA (see Warts). 
VERTIGO. 

Alkalies, if stomachal, 483 et al. 

Hydrobromic acid, dilute, 302. 

Potassium bromide in uncomplicated 
cases, 298. 

Quinine, if aural, 160. 
VIRUS OF RABID OR VENOM- 
OUS ANIMALS. 

Alcohol to counteract poison of, 214. 

Ammonia water, 218; topically, 561. 

Escharotics, 562, et al. 

Ligature between heart and wound 
which should be sucked to withdraw 
virus. 



682 



INDEX OF DISEASES AND REMEDIES. 



VIRUS OF ANIMALS (continued). 

Potassa, 563. 

Potassium permanganate solution in- 
jected into snake bite wounds 499. 

Silver nitrate as caustic, 204. 

Sodium bicarbonate and common salt, 
489. 
VOMITING. 

Apollinaris water, 572. 

Alkalies, 484. 

Bismuth subnitrate, 206. 

Caffeine valerianate in hysterical, 134. 

Carbonic acid water, 572. 

Calomel, 450. 

Creosote, 517. 

Hydrocyanic acid, dilute, 309. 

Ice, cracked, swallowed, 37. 

Ingluvin, 166. 

Lime water, 494. 

Mineral waters, carbonated, 572. 

Opium, 89. 

Spice plaster, 555. 
VOMITING OF PREGNANCY. 

Calumba, 147. 

Cerium oxalate or nitrate, 207. 

Ingluvin, 166. 

Iodine tincture, 460. 

Ipecac, 327. 

Potassium bromide, 299. 

Strychnine, 264. 
WARTS. 

Acetic acid, 258. 

Chromic acid, 564. 

Escharotics, 562 et al. 

Nitric acid, 172, 566. 

Potassium bichromate, 483. 

Salicylic acid, 530. 

Silver nitrate, 204, 562. 
WATER BRASH (see Gastritis, 

Chronic). 
WHOOPING COUGH. 

Ammonium bromide, 301. 

Atropine sulphate to allay spasms of, 
102. 

Carbolic acid spray, 514; by vapor- 
ization, 514-15. 

Chloral, 295. 

Eucalyptus oil, 150. 

Hydrocyanic acid, dilute, 309. 

Hyoscine hydrochlorate, 109. 

Ipecacuanha, 326. 

Potassium bromide, 298. 
WORMS, ROUND (Ascaris Lumbri- 
coides; see also Appendix for 
Parasites). 

Calomel, 450, 606. 

Carbolic acid, internally, 513. 

Chenopodium, fruit, or oil, 603. 

Cod liver oil as clyster, 468. 

Diet : restricted while under treatment. 
168. 



WORMS, ROUND (continued). 

Santonin, or troches of, the best 

remedy, 604. 
Spigelia, 601. 
Turpentine oil, 407, 606. 
Worm tea, 601. 
WORMS, THREAD (Oxyuris Ver- 

micularis ; see also Appendix). 
Anthelmintic enemata, 376. 
Calomel, 450, 606. 
Carbolic acid enemata, 514. 
Cod liver oil as clyster, 468. 
Green vegetables cooked or uncooked 

to be avoided. 
Leptandra as cathartic, 360. 
Quassia infusion by injection, 145. 
Turpentine oil, 408, 606. 

WORMS, TAPE (Taenia Solium; 
see Appendix for Parasites). 
Aspidium, very efficacious, 605. 
Carbolic acid, internally, 513. 
Cusso (Bray era), 607. 
Gamboge, 371. 
Granatum, 606. 
Kamala (Rottlera), 607. 
Koossin, 607. 
Pelletierine tannate, 605. 
Pumpkin seed, very efficacious, 608. 
Turpentine oil, 606. 

WOUNDS. 

Arnica lotion, 247. 

Boric acid, 506 ; as Ointment, 506. 

Corrosive sublimate dressing, gauze, 

lint, cotton, solutions, etc., 501-2. 
Adhesive plaster, 594. 
Iodoform, 542. 
Linimentum saponis, 1 31. 
Lister's method with carbolic acid, 

5I5- 
Silver nitrate, 204; to granulations 
of, 562. 

WRITERS' CRAMP. 

Electricity, 43. 
- Massage, 47. 
Rest. 

YELLOW FEVER. 

Calomel, 450. 

Castor oil purge, 336. 

Champagne iced, for gastric irrita- 
bility, 215. 

Diet : milk and beef tea (see Dietary 
in Appendix). 

Ice, cracked, to check vomiting, 37. 

Ipecac emetic at onset, 326; followed 
by full dose of quinine, 161. 

Lead acetate, and opium to check 
transudation through intestinal wall, 

194. 

Mustard foot-bath, hot, at onset, 553. 
Sternberg's alkaline treatment, 489. 



INDEX TO CONTENTS. 



Abbreviations and signs, table of, 612 
Abies balsamea, 405 

excelsa, 554 
Abscesses, application of remedies to, 

73,80 
Absinthe, 152 
Absinthin, 152 
Absinthium, 152 
Absorbents, action and division of, 592 ; 

list and uses of, 596 et al. 
Absorption of medicines, 53 
Acacia, 572 

catechu, 184 

Senegal, 572 
Aceta, 61 
Acetanilid, 520 
Acetanilidum, 520 
Acetic ether, 119 
Acetum opii, 92 

scillse, 391 
Acetyl-amido-salol, 534 
Acid, acetic, chemistry, 52 ; action and uses 
of, 257-8 ; glacial, 258 

aconitic, 235 

anemonic, 246 

angelic, 321 

anthemic, 151 

arabic, 573 

arsenous, action and uses of, 469 ; as 
eschar otic. 564 

artanthic, 415 

benzoic, plant-constituent, 420, 421, 
422 ; chemistry of, 509 ; action and 
uses of, 524 

boheic, 133 

boracic, 505 

boric, 505 

butyric, 373 

caffeo-tannic, 133 

caffeic, 133 

cambogic, 371 

camphoric, 129 

carbolic, chemistry of, 509 ; action and 
uses of, 510; hypo. 636 

carbonic, 572 

carminic, 599 

catechu-tannic, 184 

cathartic, 358 

chelidoninic, 366 

chromic, 563 



Acid, chrysophanic, 354, 567 
cincho-tannic, 155, 180 
cinnamic, 420, 421, 422 _ 
citric, chemistry, 52 ; action and uses 

of, 257-8 
coca-tannic, 135 
columbic, 147 
copaivic, 410 
cubebic, 413 
cyanhydric, 307 
digitalic, 277 
ergotinic, 271 
erucic, 551 
euonic, 368 
ferulic, 127 
filicic, 604 
gallic, 182 
gelseminic, 315 
gentisic, 145 
glycoholic, 167 
guaiacic, etc. , 383 
gummic. 573 
hydriodic, 466 
hydrobromic, dilute, 301 
hydrochloric, 172 ; dilute, 173 
hydrocyanic, dilute, 307 
hypophosphorous, dilute, 175 
igasuric, 260 
ipecacuanhic, 325 
iso-heptoic, 233 
kinic, 155 
kino-tannic, 185 
kinovic, 155 
kramero-tannic, 185 
lactic, 175 
lobelic, 305 

meconic, 83 ; as test for opium, 85 
nitric, 171 ; dilute, 172 
nitro-hydrochloric, 173 ; dilute, 174 
oenanthic, 215 
oleic, 585 
ophilic, 148 
phenic, 510 
phosphoric, 174 
picropodophyllic, 364 
polygalic, 401 
prussic, 307 
pyroligneous, 408 
querci-tannic, 187 
quillaiic, 402 

683 



684 



INDEX. 



Acid, rheotannic 354 
rheumic, 354 
ricinic, 336 
salicylic, chemistry of, 509 ; action and 

uses of, 527 
santalic, 599 
sclerotic, 271 
spliacelinic, 271 
stearic, 586 

sulphuric, 170; aromatic, and dilute, 171 
sulphurous, 503 
tannic, chemistry, 52; action and uses, 

180 
tartaric, chemistry, 52; action and uses 

of, 257-9 
thebolactic, 83 
tiglinic, 373 
toxicodendric, 268 
tropic, 107 
valerianic, 131, 373 
Acida mineralia, action and uses, 169 ; as 

escharotics, 566 
vegitabilia, 257 
Acids, mineral, action and uses of, 169 ; as 

escharotics, 566 
vegetable, chemistry of, 50, 52 ; 257 
Acidum, aceticum, chemistry, 52, action 

and uses of, 257-8; dilutum, 258; 

glaciale, 258 
arsenosum, action and uses of, 469 ; 

as escharotic, 564 
benzoicum, 524 
boricum, 505 
carbolicum, 510; hypodermic solution 

of, 636 

crudum, 510 ; as disinfectant, 515 
chromicum, 563 

citricum, chemistry, 52; 257; prepa- 
ration and uses of, 258 
gallicum, 182 

hydrobromicum dilutum, 301 
hydrochloricum, 172 

dilutum, 173 
hydrocyanicum, dilutum, 307 
hypophosphorosum dilutum, 175 
lacticum, 175 
nitricum, 171 

dilutum, 172 
nitro-hydrochloricum, 173 

dilutum, 174 
oleicum, 585 
phosphoricum, 174 

dilutum, 174 
salicylicum, 527 
sulphuricum, 170 

aromaticum, 171 
dilutum, 171 
stearicum, 586 
sulphurosum, 503 
tannicum, chemistry, 52, action and 

uses, 180 
tartaricum, chemistry, 52, action and 

uses, 257-9 



Acipenser huso, 594 

Aconine, 235 

Aconite, 235 

Aconitine, 235 ; action and dose of, 240 

Aconitum, 235 

Aconitum napellus, 235 

Acorine, 229 

Acorus calamus, 228 

Acrinyl sulphocyanide, 552 

Actual cautery, 34 

Acupuncture, 26, uses of, 29 

Adeps, 584 

benzoinatus, 420, 584 

lanae hydrosus, 584 

myristicae, 225 
Adhesive plaster, 594 
Adonidine, 281 
Adonis vernalis, 281 
^Ether, 115 

aceticus, 119 
Albuminous principles, 50 
Agropyrum repens, 397 
Aix-la-Chapelle Springs, Prussia, 340 
Aix-les-Bains Springs, Savoy, 340 
Alcohol, 210; absolutum, 215; amylic, 

311; deodoratum, 215; dilutum, 215; 

glyceric, 587 
Alcoholic liquors, table of strength of, 637 

potassa, 562 
Alder Buckthorn, 359 
Ale, 216 
Algas, 581 
Alkaline carbonates, as diuretics. 388 

mineral waters, American, 489 

mineral waters, European, 490 

salts, as diuretics, 388 
Alkaloids, chemistry of, 50 
Allium, action and uses of, 403 

sativum, 403 
Allspice, 226 

Allyl, 403, sulphocynide, 551 
Almond, bitter, 311, emulsion, 574 

oil, 310, spirit, 311, syrup, 311 

sweet, 311 

water, bitter. 311 
Aloe, purificata, 357, vera, 356 
Aloes, action and uses of, 356 ; as emmena- 
gogue, 423 

Barbadoes, 356 

Socotrine, 356 
Aloin, 356, 357 
Aloinum, 356, 357 
Alpena Well, Michigan, 340 
Alteratives, 81 ; effects of, 438 ; uses of, 439 
Alterative diaphoretics, 380 
Althaea, 577 

officinalis, 577 
Alum, action and uses of, 207 ; as emetic. 
331 ; as escharotic, 566 

ammonio-ferric, 436 

dried, 207; waters, 209; whey, 209 
Alumen, 207 

exsiccatum, 209 



INDEX. 



685 



Aluminii hydras, 209 

sulphas, 209 
Alumnol, action, 549; solutions, etc., 647 
Amanita muscara, 110 
American Hellebore, 241 

white turpentine, 404 

wormseed, 602 
Ammonia and its preparations, 217 

aromatic spirits of, 219, 493 

water, 218, stronger, 218, and as vesi- 
cant, 561 ; as antacids, 493 
Ammoniac, 128; plaster with mercury, 444-6 
Ammoniacum, action and uses of, 128; 

with expectorants, 423 
Ammonias aqua, 218 ; aromatic spirits, 219, 
493 

fortior, 218, as vesicant, 561; 

prseparata, action and uses of, 217; 
as antacids, 493 
Ammoniated mercury, 444 ; action and uses 
of, 456 

glycyrrhizin, 579 
Ammonii benzoas, 525 

bromidum, 300 

carbonas, 220 

chloridum, 219 

iodidum, 465 * 

nitras, 221 

prseparata, action and uses of, 217 ; as 
antacids, 493 

valerianas, 132 
Ammonium benzoate, 525 

bromide, 300 

carbonate, 220 

chloride, 219 

iodide, 465 

nitrate, 221 

preparations, action and uses of, 217 ; 
as antacids, 493 

valerianate, 132 
Ampere, 40 
Amygdalin, 52, 310 
Amygdala amara, 311 

dulcis, 311 
Amygdalus communus, 310 
Amyl hydrate, 311 

nitris, 311 

nitrite, 311 
Amylum, 582 
Anacardiae, 268, 422 
Anacyclus Pyrethrum, 422 
Anaesthetics, 81 ; action, list and uses of, 115 
Analgene, 647 
Anamirta Paniculata, 268 
Andira araroba, 567 
Anemone Pulsatilla and Pratensis, 246 
Anhidrotics, 377 
Aniline, chemistry of, 509 ; poisoning by, 

519 
Animal charcoal, 597 

fats, 583 
Anise, 234 



action and uses of, 483 

81 ; list, division and action 



Anise oil, 234 

star, 234 

water, 234 
Anisum, 234 
Anode, 40 
Anodynes, 81 
Antacids, 81 ; 
Anthelmintics, 
of, 599 
Anthemis, 151 

nobilis, 151 
Anthracene, 509 
Antifebrin, 520 
Antimonii oxidum, 249 
praeparata, 249 

et potassii tartras, 249 

sulphidum, 252 

purificatum, 252 

sulphuratum, 252 
Antimonial ointment, 561 
Antimony and its preparations, 249 
Antipyretics, defined, 497 
Antipyrine, chemistry of, 510; action and 
uses of, 536 ; hypodermic solution of, 
636 ; salicylate, 538 
Antiseptics, 81, and. antipyretics, 496 
Antispasmodics, 81 ; action and uses of, 

126 
Antitoxine, 647 
Apiol, 426 

Apis mellifica, 585, 591. 
Apocynacese, 282, 322, 395 
Apocynein, 395 
Apocynin, 395 
Apocynum, 395 

cannabinum, 395 
Apollinaris water, analysis of, 490; uses, 

572 
Apomorphinae hydrochloras, 329 ; hypoder- 
mic solution of, 636 
Apomorphine hydrochlorate, 329 
Aporetin, 354 
Apothecaries' measure, 63, 65, 615 

weight, 65 
Aqua, 571 

ammonias, 218 

fortior, 218 ; as vesicant, 561 

amygdalae amarae, 311 

anisi, 234 

aurantii fiorum, 231 

fortior, 231 

camphorae, 130 

chlori, 499 

chloroformi, 122 

cinnamomi, 224 

creosoti, 518 

destillata, 571 

fceniculi, 234 

hydrogenii dioxidi, 503 

menthae piperitae, 233 
viridis, 233 

picis liquidae, 408 



686 



INDEX. 



Aqua rosae, 189 

fortior, 189 
Aquae, 58 
Arabin, 51, 573 
Araroba, 567 

Arbutin, 230, 416 ; dose of, 417, 418 
Arctostaphylos uva ursi, 416 
Argenti cyanidum, 205 

iodidum, 205 

nitras, 201 

dilutus, 204 

fusus, 204; as escharotic, 562 

oxiduru, 205 

praeparata, 201 
Argyria, 201 
Aristol, 542 

Aristolochia Serpentaria, 148 
Aristolochiaceae, 148 
Arkansas hot springs, 34 
Arnica, 246 

Montana, 246 
Arnicin, 247 
Aroideae, 228 
Aromatics, 221 

Aromatic spirit of ammonia, 219, 493 
Arrowroot, 609 
Arsenic, its preparations, actions and uses, 

469 ; hypodermic solution of, 636 
Arsenic oxide, 469; iodide, 477 
Arsenii iodidum, 477 

praeparata, 469 
Artemisia absinthium, 152 

maritima, 603 
Arteriotomy, 26 
Artium lappa, 386 
Asafetida, 126 

Asafoetida, action and uses of, 126; as ex- 
pectorant, 423 
Asagraea officinalis, 244 
Asclepiadeae, 386 
Asclepias, 386 

tuberosa, 386 
Ascending current, 40 
Asparagin, 578, 579 
Aspidium, 599; action and uses of, 604; 

filix-mas, 604 
Aspidol, 605 
Aspidosamine, 322 
Aspidosperma, 322 

quebracho-bianco, 322 
Aspidospermatine, 322 
Aspidospermine, 322 
Aspiration, 26; action of, 29; uses of, 31 
Aspirator, 29 
Astragalus gummifer, 574 
Astringents, 81; action, uses and division 

of, 179 
Atomization of fluids, 76, 77 
Atomizers, 77, 78 

Sajou's modification of, 77 

Sass', 78 

Siegele's, 78 



Atomizers, Snowden's, 77 
Atropa belladonna, 98 
Atropina, 99 
Atropine, 99 ; with mydriatics, 110 

in ophthalmic practice, 103 

sulphate of, 104 ; hypodermic solution 
of, 636 
Auditory canal, application of medicines 

to, 76 
Aurantii amari cortex, 230 

dulcis cortex, 230 
Auri et sodii chloridurn, 458 
Auranticeae, 231 

Baden-Baden Spring, 352 
Bagneres-de-Bigorre Spring, 496 ; de Bar- 
eges, 341 
Ballston Spa waters, 493 
Balm, 386 

Balsam of fir, 405 ; of copaiba, 410 ; defi- 
nition of, 410; of Peru, 421; of 
Tolu, 421 

Gilead tree, 405 
Balsams, composition of, 51 [^21] 

Balsamum Peruvianum, action and uses of, 

Tolutanum, action and uses of, 421 
Bagneres de Luchon, 341 
Bandage, plaster of Paris, 592 

silica, 593 
Bandages, 26, 28 

elastic, 28 

plaster of Paris, 592 

silica, 593 
Barbaloin, 356 
Bareges Springs, 341 
Barium dioxide, 502 
Barley, 216 
Barley water, 576 

Barosma betulina, 416 ; crenulata, 416 
Basham's mixture, 434 
Basic quinine sulphate, 162 

ferric sulphate, 432 
Basilicon ointment, 594 
Bassorin, 573 

Bath County Hot Springs, 34 
Bath Alum Springs, 209 
Baths, 33, 34, 36 

cold, 35 

plunge, 36 
shower, 36 

contra-indications, 35 

hip, 33 

hot, 33 

air, 34 
plunge, 33 

Sitz, 33 

tepid alkaline, 34 

warm, 33 
Bay rum, 216 

Bearberry, 416 [641 

Bed-bug, remedy for, 502; description ofj 
Bedford Chalybeate Spring, 490 






INDEX. 



687 



Beef essence, or tea, 609; peptonized, 

610 
Bee honey, 585, 591 
Beers, alcoholic strength of various (see 

Appendix, 637) 
Beet-root, 590 
Belladonna, 98 
Belladonnine, 99 
Benjamin tree, 419 
Benzalcohol, 421 

Benzin, chemistry of, 508, 509 ; poison- 
ing by, 510 ; action and uses of, 519 
Benzinum, 519 

Benzoic acid, 420, 421 ; action and uses of, 
524 

aldehyde, 310 
Benzoin, 419; in tears and sorts, 420 
Benzoinated lard, 420, 584 
Benzoinum, action and uses of, 419 
Benzol, 508 ; poisoning by, 510 
Benzosol, 648 
Benzyl-quinine, 510 

tropin e, 510 
Benzylic benzoate, 421, 422 ; cinnamate, 

421, 422 
Berberacese, 147 
Berberidege, 363, 426 
Berberine, action and uses of, 147 ; drugs 

found in, 266, 385, 415 
Berzelius-Marsh-test for arsenic, 470 
Beta vulgaris, 590 
Betulacese, 230 
Betula lenta, 230 
Bhang, 111 
Biliverdin, 167 

Bismuth and its preparations, 205 
Bismuthi et ammonii citras, 2(J6 

citras, 206 

prseparata, 205 

subcarbonas, 206 

subnitras, 205 

valerianas, 207 
Bitter almond water, 310 

cucumber, 369 

orange, 230 
peel, 230 
Bitter-extractive, defined, 50, 52 ; in tonics, 

144 
Bittersweet, 114 
Bitter wine of iron, 436 
Bitters, aromatic, active ingredients of, 144 ; 
list, action and uses of, 148 

astringent, active ingredients of, 144 ; 
list, action and uses of, 154 

pure, 144 
Blackberry, 190 

draught, 357 

haw, 318 

pepper, 223 

snakeroot, 285 

wash, 448 
Blanc-mange, 582 



Blaud's pills, 430 
Blount Springs, Alabama, 340 
Blennorrhetics, 81 ; as diuretics, 387, 388 ; 
action, uses and classification of, 
400 
Blistering cerate, 556 
Blisters, 550 ; action and uses of, 555 
Blood-letting, 26, 27 

medicinal uses of, 26 
Bloodroot, 327 
Blue-cohosh, 426 ; flag, 366 

gum-tree, 149 

mass, as cathartic, 375 ; action and 
uses of, 444 

ointment, action and uses of, 445 

pill, as cathartic, 375 ; uses of, 444 

stone, 197 ' 

vitriol, 197 
Bolus, 57 

Bone phosphate of calcium, 478 
Boneset, 151 
Bonjean's ergotine, 275 
Boracic acid, 505 
Borax, 507 
Boric acid, 505 

Bourbonne Spring, France, 352 
Bran, as laxative, 332 ; as protectant, 592 ; 

as dressing, 598 
Brandy, 216 

Brassica, alba and nigra, 550 
Brayera, 606 
Bromine, as antiseptic, 503 ; as escharotic, 

564. 
Bromoform, 648 

Bromum, action and uses of, 564 
Broom, 399 
Brown mixture, 580 
Brucine, 260-1 
Bryonia, 363 

alba, 363 

dioica, 363 
Bryonin, 363 
Bryony, 363 
Bryoresin, 363 

Buchu, actions and uses of, 416 
Buckthorn, 359 
Buffalo Lithia Springs, 493 
Burdock, 386 

Burgundy pitch, 554 ; spurious, 554 
Burmese itch, parasite, etc., of, 639 
Burnett's disinfecting fluid, 201 
Burseracese, 419 
Butter of cacao, 586, 587 
Butternut, 355 
Buxine, 415 

Cacao-butter, 586, 587 
Cadinene, 232, 424 
Caffea, 133 
Caffeina, 133 

action and use of, 134 

citrata, 134 



6S8 



INDEX. 



Caffeina citrata effervescens, 134 
Caffeine, action and use of, 134 

citrate and valerianate, 134 

plant-ingredient, 133-4, 141 
Calabar bean, 290 
Calabarine, 290 
Calamus, 228 
Calcareous waters, European, 496 

North American, 496 
Calcii bromidum, 301 

carbonas praecipitatus, 495 

chloridum, 479 

hypophosphis, 478 

phosphas praecipitatus, 478 

praeparata, 494 

sulphas exsiccatus, 592 
Calcium bromide, 301 

carbonate, precipitated, 495 

chloride, 479 

hypophosphite, 478 

phosphate, precipitated, 478 

preparations, 494 

sulphate, dried, 592 
Caledonia Springs, Canada, 350 
Calendula, 385 

officinalis, 385 
Calendulin, 385 
Calisaya bark, 154 

Calomel, as cathartic, 374, 444; action 
and uses of, 449; by fumigation, 
451; as vermifuge, 5£9, 606 
Calor, 32 
Calumb, 146 
Calumba, 146 
Calx, 494 

chlorata, 500 

sulphurata, 505 
Cambogia, 370 
Campeachy wood, 186 
Camphor, action and uses of, 128 ; as 
rubefacient, 555 

artificial, 129 

cearate, 13 L 

cream, 131 

liniment, 130 

spirit, 130 

water, 130 
Camphora, 128 
Camphora cinnamomum, 128 

monobromata, 131 
Canada balsam, 405 ; fleabane, 395 
Canadian hemp, 395 ; moonseed, 388 
Canadine, 266 
Cannabin, 112 

Cannabis indica, 111; sativa, 111 
Cannabinone, 112 
Cantharidal collodion, 560 
Cantharidin, 557, 561 
Cantharides, as diuretic, 399 ; as emmena- 
gogue, 423 ; action and uses of, 556 
Cantharis, as diuretic, 399 

vesicatoria, action and uses of, 556 

vittata, 560 



Caoutchouc, 593 
Capon Springs, 490 
Caprifoliaceae, 318, 319, 400 
Capsaicin, 222 

Capsicum, action and uses of, 222; as 
rubefacient, 553 

fastigiatum, 222 
Capsules, gelatin, 57 

Carbolic acid, action and uses of, 510 ; hy- 
podermic solution of, 636; chem- 
istry, 509 ; crude, 510 ; as disin- 
fectant, 515 
Cavbo animalis, 596 ; preparation of, 597 ; 
purificatus, 597 

ligni, 596 
Carbon disulphide, 125 

disulphidum, 125 
Carbonic acid gas, 572 ; water, 572 
Cardamom, 227 
Cardamomum, 227 
Carlsbad Spring, Bohemian, 352 
Carminatives, 221 
Carminic acid, 599 
Carolina jasmine, 315 

pink, 600 
Carragheen, 581 
Carragheenin, 581 
Carron oil, 495 

Use of, 575 
Carthagena barks, 154 
Carum, 234 

carvi, 234 
Caryophyllin, 225 
Caryophyllus, 225 
Cascara sagrada, 360 
Cascarilla, 153 
Cascarillin, 153 
Cassia, cinnamon, 224 ; senna, 357 

acutifolia, 358 

angustifolia, 358 

fistula, 333 

purging, 333 
Castanea, 190 

dentata, 190 
Castor oil, 334 
Catamenia, 423 
Cataplasmata, 63 
Cataplasms, definition of, 63 ; action and 

uses of, 570 
Catechin, 184 
Catechu, 184 
Catechu-tannic acid, 184 
Cathartics, 331 

hydragogue, 361 

saline, 341 
Catharto-mannit, 358 
Cathode, 40 
Catoosa Springs, 496 
Caulophylline, 426 

Caulophyllum, action and uses of, 426 
Caulophyllus thalictroides, 426 
Caustic potassa, 562 

soda, 563 



INDEX. 



689 



Cauterants, 561 
Cauterization, 34 

by heat, 34 
Cayenne pepper, 222 
Central galvanization, 40 
Celandine, 365 
Celastrinese, 367 
Cellulin, 595 

Cephaelis ipecacuanha, 324 
Cera alba, 585 

flava, 585 
Cerata, 62 

Cerate, 63 ; composition of, 584 ; of cam- 
phor, 131 

cantharides, 559 

lead subacetate, 195 

resin, 594 

spermaceti, 585 
Cerates, 62 

Ceratum, 63 ; composition of, 584 
Ceratum camphorse, 131 

cantharides, 559 

cetacei, 585 

plumbi subacetatis, 195 

resinae, 594 
Cerii oxalas, 207 

oxalate, 207 
Cerite, 207 

Cerium nitrate, 207; oxalate, 207 
Cetacea, 585 
Cetaceum, 585 
Cetraria, 580 
Cetin, 585 

islandica, 580 
Cetrarin, 580 
Cetyl palmitate, 585 
Chalk, 495 

French, 596 

mixture, 495 
Chalybeates, 427 
Chalybeate waters, North American, 437 

European, 438 
Chamomile, 151 

German, 151 
Champagne, 215 

Charcoal, 592; action and uses of, 596; 
animal, 596; purified, 597 ; prepa- 
rations, 597 
Charpie, 576 

Charta potassii nitratis, 255 
Chartse, 58 
Chelerythrine, 365 
Chelidonine, 365 
Chelidonium, 365 

majus, 365 
Chenopodiacese, 602 

Chenopodium, 599; action and uses of, 
602 _ 

ambrosioides, 602 
Chestnut, 190 
Chian turpentine, 405 
Chicken tea, 609 

44 



Chimaphila, action and uses of, 417 

umbellata, 417 
Chimaphilin, 418 
Chinocine, 510 
Chinoline, 509, 510 
Chirata, 148 
Chiratin, 148 
Chittem bark, 360 
Clarified honey, 591 
Chloral, 292 

hydrate, 293 
Chloralamide, 97 
Chloride of ammonium, 219 

gold and sodium, 458 

iron, 434 

of lime, 500 

mercuric, 451 

mercurous, 449 
Chlorinated lime, 500 
Chlorine, 499 

water, 499 
Chlorodyne, 123 
Chloroform, 120 

emulsion, 123 

liniment, 123 

spirit, 123 

water, 122 
Chloroformum, 120 
Chocolate, 134 

nuts, 586 
Cholesterin, 142 
Choline, 112 

Chondodendron tomentosum, 4] 5 
Chondrus, 581 

crispus, 581 

mammilosus, 581 
Chromic acid, 563 

anhydride, 563 
Chromogene, 275 
Chrysarobin, 567 
Chrysarobinum, 567 
Chrysophan, 354, 358 
Chrysophanic acid, 354, 567 
Churchill Alum Spring, 209 
Churrus, 111 
Cimicifuga, 285 

racemosa, 285 
Cinchona, 154 

alkaloids of, 155-6, 162-3-4 

calisaya, 154 

condaminea, 155 

flava, 154 

rubra, 154 

succirubra, 154 
Cinchonicine, 155 
Cinchonidinaa sulphas, 164 
Cinchonidine, 156 
Cinchonina, 155 
Cinchoninae sulphas, 163 
Cinchonine, 155-6 
Cineol, 226, 232 
Cinnamein, 421 



690 



INDEX. 



Cinnamomum, 224 

cassia, 224 

Ceylon, 224 

saigonicum, 224 

zeylanicum, 224 
Cinnamon, 224 

Ceylon, 224 

China, 224 

Saigon, 224 . 

water, 224 
Circumstances modifying trie effects of 

medicines, age, dosage, etc., 71 
Cissampeline, 415 
Citrine ointment, 457 
Citrated caffeine, 134 
Citrullus colocynthis, 369 

bergamia, 234 
Citrus aurantium, 230 

limonum, 259 

vulgaris, 230 
Classification of medicines, 80 
Claviceps purpurea, 269 
Cloves, 225 
Club-moss, 596 
Clysmic water, 572 

Clysters, 79 ; action, division and uses of, 375 
Coal tar, 408 
Cobalt ores, 469 
Coca, 135 
Cocaine, 135 
Cocaine-habit, 137 
Cocainae hydrochloras, 135; hypodermic 

solutions of, 636; dose of, 141 
Cocculus Indicus, 268 

palmatus, 146 
Coccus, 599 

cacti, 599 
Cochineal, 599 
Codamine, 83 
Codeina, 84, 93 

Codeine, 83, 84 ; action and uses of, 93 
Cod, common, 466 
Cod-liver oil, 466 
Coffea arabica, 133 
Coffee, 133 

Cohosh, 285 ; blue, 426 
Coil, primary, 39 

secondary, 39 
Colchicein, 392 
Colchicine, 392; dose of, 394 
Colchicum, action, uses, and preparations, 

391 

autumnale, 391 
Cold 32, 35 

bath, 35, 36 

contraindications for, 37 

compresses, 36, 37 

cream, 189 

douche, 36 

injections, 37 

liquids, 37 

medicinal uses of, 35 



Cold pack, 36 

physiological effects of, 35 

wet-sheet, 36 
Coleoptera, 556 
Colica pictonum, 192 
Collodion, 595 ; iodized, 595 
Collodium, 595 ; action and uses, 595 

cantharidatum, 560 

flexile, 592 ; uses of, 596 

stypticum, 182, 432, 592 ; uses, 596 
Collyria, 75 

antiseptic, 

astringent, 

caustic, J- 75 

mydriatic, 

soothing, 
Colocynth, 369 
Colocyntbin, 369 
Colocynthis, 369 
Colocynthitin, 369 
Colombian barks, 154 
Colombin, 147 
Colophony, 594 

Coloring agents, 81 ; list and uses of, 598 
Columbo, 146 
Commiphora myrrha, 419 
Composite, 93, 151, 152, 246, 320, 385, 

386, 395, 396,422, 425, 426, 603 
Compound cathartic pills, 371 

iron mixture, 430 

spirits of ether, 142 

effervescing powder, 348 ; chalk pow- 
der, 495 
Compressed pills, 58 
Condy's fluid, 499 
Confectiones, 58 
Confections, 58 
Confectio rosse, 189 

sennse, 359 
Conhydrine, 287 
Conidia, 270 

Coniferse, 398, 404, 405, 423, 454 
Conine, 287 
Conium, 287 

maculatum, 287 
Contrexville water, 496 
Convallarise, 285 

majalis, 285 
Convallamarin, 285 
Convallarin, 285 
Convolvulacese, 361, 368 
Convolvulin, 361 
Convolvulus scammonia, 368 
Copaiba, action and uses of, 410 ; emulsion, 
312; dose of resin, 621 

Langsdorffii, 410 
Copper preparations, 196, oleate, 198 

sulphate, action and uses of, 197 ; as 
emetic, 331 ; escharotic, 566 
Copperas, 431 
Coriander, 234 
Coriandrum, 234 



INDEX. 



691 



Coriandrum sativum, 234 
Corn-silk, 399 
Cornutin, 271 

Corrosive mercuric chloride, 444; action 
and uses of, 451; as topical anti- 
septic, 501 ; as escharotic, 465 

sublimate, 444; action and uses of, 
451 ; hypodermic injection of, 453, 
and 637 ; as topical antiseptic, 
501 ; as escharotic, 465 
Cosmoline, 589 
Cotton, 592 ; uses and sorts of, 597 

absorbent, 597 

antiseptic, 597 

borated, 598 

boro-, 598 

carbolized, 598 

gun, 595 

holder, 76 

iodoform, 597 

purified, 597 

root, bark of, 275 

salicylated, 598 

sublimated, 501, 598 

seed oil, 576 

stupes, 597 

styptic, 432 

tampon, 598 
Couch-grass, 397 
Court- plaster, 594 
Cowling's scheme for graduating doses, 72 

(see Dose table, Appendix) 
Cramp bark, 319 
Cranesbill, 188 
Cream of tartar, action and uses of, 259; 

crude, 347 
Creasol, 516 

Cresol,.516; cresols, 518; tri-, 518 
Creosotal, 648 
Creolin, 518 

Creosote, constituent of tar-oil, 408 ; action 
and uses of, 516 ; water, 518 ; hypo- 
dermic solution of, 636 

carbonate, 648 
Creosote water, 518 
Creosotum, 516 
Cresson Springs, 209, 437 
Creta prseparata, 495 
Crocus, 598 

sativus, 598 
Croton oil, action and uses of, 372 ; as suppu- 
rant, 561 

liglium, 372 
Crowfoot, 188 
Crucifene, 330, 550 
Cryptopine, 84 
Cubeb, 412 

Cubeba, action and uses of, 412 
Cubebin, 412 

Cucurbitaceae, 363, 369, 371, 607 
Cucurbita pepo, 607 
Culver's root, 359 



Culver's physic, 359 
Cups, 27 
Cupping, 27 

dry, 27 

wet, 27 

medicinal uses of, 28 
Cupri prseparata, 196 

sulphas, 197 
Cupuliferae, 183, 186, 191 
Curare, 317 
Curarine, 317, 318 

hypodermic solution of, 636 
Curine, 317 
Current, primary, 39 

secondary, 39 
Cusso, 599 ; action and uses of, 606 
Cymene, 233 
Cynips querciis folii, 183 
Cypripedium, 132 

parviflorum, 132 

pubescens, 132 
Cysts, application of medicines to, 73, 80 
Cytisus scoparius, 283; action and uses 
of, 399 



Dandelion, 396 
Daniell's battery, 38 
Daphne mezereum, 383 
Daphnin, 384 
Darkness, effect of, 32 
Datura stramonium, 105 
Daturine, 105 
Deadly nightshade, 98 
Decocta, 59 
Decoctions, 59 
Decoction of barley, 576 

cetraria, 581 

poppy capsule, 82 

sarsaparilla compound, 382 
Decoctum cetrarise, 581 

hordei, 576 

sarsaparillse compositum, 382 
Delphinine, 248 
Delphinoidin, 248 
Delphisine, 248 
Delphinium staphisagria, 248 
Demulcents, 81 ; action and uses of, 569 
Depresso-motors, definition of, 259 ; group 

of, 287 
Derivatives of phenyl, 508 
Dermatol, 549 
Dermatophyti, 638-9 
Descending current, 41 
Deshler's salve, 594 
Dewberry, 190 
Dextrine, 216, 583 
Dextrogyrate, 395 
Diachylon ointment, 196 

plaster, 196 
Dialyzed iron, 437 ; hypodermic solution 
■ of, (see Appendix, 636) 



692 



INDEX. 



Diaphoretics, 81 ; action and division of, 
377 ; as aids to diuretics, 387 

alterative, 380 

nauseating, 377 

refrigerant, 377 

stimulating, 378 
Diastase, 583 
Dietary for the sick, 609 
Dieulafoy's aspirator, 29 
Digestion, 59 
Digestive ferments, 165 
Digitalein, 277 
Digitalin, 277 ; dose of, 281 ; hypodermic 

solution of, 636 
Digitalis, 277 

purpurea, 277 
Digitonin, 277 
Digitoxin, 277 
Diluents, 569 
Diosphenol, 416 
Diplolepis gallse tinctoriae, 183 
Dipterocarpacese, 128 
Disinfectants, defined, 496 
Dispensatory, 50 
Displacement, 59 
Distilled water, 571 
Distilled waters, 58 
Diuretic mixture, active, 398 
Diuretics, 81, 387; classification of, 388; 

stimulating, 388 ; special, 389 
Diuretin, 135 
Dobells solution, 78 
Donovan's solution, 477 
Dorema ammoniacum, 128 
Douche, nasal, 75 

Dover's powder, with opium, 92, 327 
Drachm, 63 
Drastic cathartics, 331 
Dried calcium sulphate, 592 
Drops, 65 

Dryobalanops camphora, 128 
Dryopteris Felix-mas, 604 

marginalis, 604 
Duboisia, 109 

myoporoides, 109 
Duboisine, 109, 110 
Dulcamara, 114 
Dulcamarin, 114 
Dupuytren's pomatum, 560 

i 
Ecballium elaterium, 371 
Eccritics, 81 ; subdivison of, 322 
Ecgonine, 135 
Effleurage, 46 

Effervescent magnesium citrate, 345 
Elastica, 592; uses, 593 
Elaterin, 371-2 
Elaterium, 371 
Elaterinum, 371-2 
Elecampane, 426 

camphor, 426 
Electric bath, 38 



Electric current,41 

shock, 38 

spark, 38 
Electrical definitions, 40 

diagnosis, 41 
Electricitas, 37 
Electricity, 32 , source of, 37 

electro-magnetic, 37 

faradic, 37 

Franklinic, 37 

friction, 37 

galvanic, 37 

induced, 37 ; action of, 39 

magneto-electric, 37 

static, 37 

Morton's method, 37 
Electro-magnetic machine, 39 
Electro-motor force, 40 
Electron, 37 
Electrodes, 39 
Electrolysis, 46 
Electro -therapy, 41 
Electrotonus, 40 
Elettaria repens, 227 
Elixir aromaticum, 231 
Elixir phosphori, 179 
Elizabeth Brunnen, 351 
Elutriation, 56 
Emetics, 81; definition, action and uses 

of, 322 
Emetine, 324 

Emmenagogues, 81 ; action and list of, 423 
Emodin, 354, 360 
Emollients, 569 
Emplastra, 63 

Emplastrum ammoniaci cum hydrargyro, 
128,444,446 

arnicse, 217 

belladonnse, 104 

capsici, 223 

fern, 430 

hydrargyri, 444 ; action and uses of, 
446 

ichthyocollse, 594 

opii, 92 

picis Burgundicse, 554 
cantharidatum, 554 

plumbi, 63; uses of, 196 

resinat, 594 

saponis, 196 
Ems water, 490 

Emulsin, 52, 58; as ferment, 310 
Emulsion, 58 

of almond, 311 ; uses of, 574 

ammoniac, 128 

asafetida, 127 

chloroform, 123 
Emulsum amygdalae, 311 ; uses of, 574 

ammoniaci, 128 

asafcetidse, 127 

chloroformi, 123 
Endermic application of medicines, 73 



INDEX. 



693 



Enemata, 79 ; kinds and uses of, 375 

anodyne, 377 

anthelmintic, 376 

astringent, 376 

defibrinated blood, 79 

emollient, 376 

forced, 375 

laxative, 375 

nutrient, 377 

peptonized, 611 

purgative, 375 
Enepidermic application of medicines, 73 
Epidermic applications of medicine, 73 
Epispastics, 549, 550 ; action and uses of, 

555 
Epsom salt, 344 
Ergot, 269 
Ergota, 269 

Ergotine, 275 ; hypodtrmic solution of, 636 
Ergotinin, 272 
Ergotism, 272 
Ericacise, 229, 416, 417 
Ericolin, 153, 230, 416 
Erigeron canadense, 395 
Eriodictyon, 153 
Errhines, 75 
Erythroxylon coca, 135 
Escharotics, 549, 550; action and uses of, 

561 
Eserine, as myotic, 110 ; 290 ; uses of, 292 ; 

hypodermic solution of, 636 
Essence of lemon, 259 

mirbane, 519 
Essential oils, definition of, 51 ; action and 

uses of, 221 ; as antiseptics, 538 
Esters, 232 
Ethal,585 
Ether, 115 ; acetic, 119 

of lauro-stearic acid, 585 

of myristic acid, 585 

spray, 35 

of stearic acid, 585 
Ethereal anaesthetics, 115 

oil, 142 

refrigerants, uses of, 256 ; 388 
Etherization, 117 
Ethyl bromide, 125 
Erythroretin, 354 
Eucalyptol, 150 
Eucalyptus, 149 

globulus, 149 
Eugenia aromatica, 225 » 

Eugenin, 225 

Eugenol, 225, 226 ; action and uses of, 546 
Euonymin, 368 
Euonymus, 367 

atropurpureus, 367 
Eupatorium, 151 

perfoliatum, 151 
Euphorbiacea?, 153, 334, 372, 386, 593, 

607 
Euphorin, 648 



Europhen, 648 

Eustachian tubes, application of medicines 

to, 76 
Evacuants, 423 
Exalgine, 522 
Excito-motors, 259, 260 
Expectorants, 400 
Extracta, 62 

fluida, 61 
Extracts, 62 ; see extractum for official 
acetic, 62 
alcoholic, 62 
watery, 62 
Eye-washes, 75 
Extractum aconiti, 241 

fiuidum, 241 
aloes, 357 

apocyni fiuidum, 396 
arnicse radicis, 247 

fiuidum, 247 
aromaticum fiuidum, 228 
asclepiadis fiuidum, 386 
aspidospermatis fiuidum, 322 
aurantii amari fiuidum, 231 
belladonna? foliorum alcoholicum, 104 
. belladonna? radicis fiuidum, 104 
buchu fiuidum, 416 
calami fiuidum, 229 
calumba? fiuidum, 147 
cannabis indica?, 113 

fiuidum, 113 
capsici fiuidum, 223 
castanea? fiuidum, 191 
chimaphilae fiuidum, 419 
chirata? fiuidum, 148 
cimicifuga?, 287 

fiuidum, 287 
cinchona?, 161 

fiuidum, 161 
coca? fiuidum, 135 
colchici radicis, 394 

fiuidum. 394 
seminis fiuidum, 394 
colocynthidis, 370 

compositum, 370 
conii, 289 

fiuidum, 290 
convallaria? fiuidum, 285 
cubeba? fiuidum, 413 
cusso fiuidum, 607 
cypripedii fiuidum, 133 
digitalis, 281 

fiuidum, 281 
dulcamara? fiuidum, 115 
ergota?, 274 

fiuidum, 274 
eriodictyi fiuidum, 154 
eucalypti fiuidum, 150 
euonymi, 368 
eupatorii fiuidum, 152 
frangula? fiuidum, 360 
gelsemii fiuidum, 317 



694 



INDEX. 



Extractum gentianae, 146 

fluidum, 146 
geranii fluidum, 188 
glycyrrhizae, 579, 580 
fluidum, 579 
purum, 580 
gossypii radicis fluidum, 276 
grindeliae fluidum , 321 
guaranae fluidum, 141 
haematoxyli, 186 
hamamelidis fluidum, 189 
hydrastis fluidum, 267 
hyoscyami, 108 

fluidum, 108 
ipecacuanha fluidum, 327 
iridis, 367 

fluidum, 367 
jalapae, 362 
juglandis, 356 
krameriae, 186 

fluidum, 186 
lappa? fluidum, 386 
leptandrae, 359 

fluidum, 359 
lobeliae fluidum, 307 
lupulini fluidum, 114 
malti, 216 
matico fluidum, 415 
menispermi fluidum, 385 
mezerei fluidum, 384 
nucis vomicae, 265 

fluidum, 265 
opii, 91 

pareirae fluidum, 415 
physostigmatis, 292 
phytolaccaa radicis fluidum, 248 
pilocarpi fluidum, 380 
podophylli, 365 

fluidum, 365 
pruni virgini arise, 165 
quassiae, 145 

fluidum, 145 
rhamni purshianae fluidum, 361 
rhei, 355 

fluidum, 355 
rhois glabrae fluidum, 190 
rosae fluidum, 189 
rubi fluidum, 190 
rubi idaei, 190 
rumicis fluidum, 189 
sabinae fluidum, 424 
sanguinariae fluidum, 329 
sarsaparillae fluidum, 382 
sarsaparillae fluidum compositum, 382 
scillae fluidum, 391 
scoparii fluidum, 399 
Scutellariae fluidum, 133 
senegae fluidum, 402 
sennae fluidum, 359 
serpentariae fluidum, 149 
spigelian fluidum, 601 
stillingiae fluidum, 386 



Extractum stramonii seminis, 106 

fluidum, 106 
taraxaci, 397 

fluidum, 397 
tritici fluidum, 398 
uvae ursi, 417 

fluidum, 417 
Valerianae fluidum, 132 
veratri viridis fluidum, 244 
viburni opuli fluidum, 320 

prunifolii fluidum, 319 
xanthoxyli fluidum, 385 
zingiberis fluidum, 227 

Fachingen water, 490 
False angustura bark, 260 
Faradic electricity, 37, 39 

current, action of, 39, 40 

excitability, 41 
Faradization, 39 
Favus, parasite, etc. , of, 639 
Fennel, 233 
Fennel oil, 234 

water, 234 
Fel bovis, 167 

purificatum, 167 
Ferments, 50, 52 
Ferri carbonas saccharatus, 430 

carbon atis massa, 430 

chloridum, 432 

citras, 435 

et ammonii citras, 436 

et ammonii sulphas, 436 

et ammonii tartras, 437 

et potassii tartras, 434 

et quininae citras, 436 

solubilis, 436 

et strychninae citras, 436 

hypophosphis, 435 

iodidum saccharatum, 434 

lactas, 435 

oxidum hydratum, 429 
cum magnesia, 430 

phosphas solubilis, 434 

praeparata, 427 

pyrophosphas solubilis, 435 

sulphas, 431 

exciccatus, 431 
granulatus, 431 

valerianas, 437 
Ferric acetate, 435 

ammonium sulphate, 436 

chloride, 432 

citrate, 435 ; hypo., 636; wine of, 436 

hydrate, 429 ; with magnesia, 430 

hypophosphite, 435 

sulphate, solution of, normal, 431 

valerianate, 437 
Ferrous carbonate, 430 

iodide, 434 

lactate, 435 

sulphate, 431; dried and granulated,431 



INDEX. 



695 



Ferruginea, 427 

Ferrum, 427; dialysatum, 437 ; hypodermic 

solution of, 636 

reductum, 429 
Ferula fcetida, 126 

sumbul, 321 
Ficus, 332, 333 

carica, 333 
Fig, 332, 333 
Filices, 604 

Fir, American silver, 405 
Flaxseed, see linseed, 574 
Flea, parasite and remedy, 641 
Fluid extracts, 61 ; for list of, see ex- 

tractum and extracts 
Fluidounce, 65 
Fluidrachm, 65 
Fly-fungus, 110 
Fceniculum, 233 

capillaceum, 233 
Fomentations, 33 
Fonticuli, 28 
Foxglove, 276 
Fowler's solution, 475 
Frangula, 359 
Frangulin, 360 
Fraxin, 333 
Fraxinus ornus, 333 
French chalk, 496 
Freezing mixture, 125 
French juniper tree, 408 
Friar's balsam, 420 
Friction, 26, 28, application of medicines 

by, 73 
Friedrickshall Spring, Germany, 352 
Frigus, 35 
Fuller's alkaline treatment, 487 

lotion, 488 
Fumigation, 73 

with calomel, 451 
Fungi, 269 
Furfur, 598 
Fused silver nitrate, 562 



Gadida, 466 
Gaduin, 466 
Gadus morrhua, 466 
Galla, 183 
Gallanol, 549 
Gall oak, 183 
Gallon, 65 
Galvanic battery, 38 

excitability, 41 
Galvanism, 38 
Galvano-cautery, 46 
Gamboge, 370 
Garcinia hanburii, 370 
Gargansmata, 76 
Gargles, 76 
Gargling, 76 
Garlic, 403 
Gases, 56 ; how used, 63 



Gastric lavage, 26, uses of, 31 
Gaultheria, 229 

procumbens, 229 
Gauze, sublimated, 501 
Gelatin, 595 

capsules, 57 
Gelsemine, 315 ; dose of, 317 
Gelsemium, 315; sempervirens, 315 
General circumstances which modify the 

effects of medicines, 54 
General faradization, 40 
Gentian, 145 

yellow, 145 
Gentiana, ]45 

lutea, 145 
Gentianacese, 145, 148 
Gentiopicrin, 145 
Gentisin, 145 
Geraniacese, 188 
Geraniol, 231 
Geranium, 188 

maculatum, 188 
Germicides defined, 496 
Giesshiibler water, 572 
Gilbert's syrup, 465 
Gin, 216 

Ginger, action and uses of, 226 ; as rube- 
facient, 555 

black, 226 

Jamaica, 226 

white, 226 
Gingeroi, 227 
Glacial acetic acid, 258 
Glauber's salt, 345 
Glonoin, 313 

Glucosides, definition of, 50, 52 
Glycerin, 587 

rectal injection of, 588 

suppositories, 589 
Glycerinum, 587 
Glycerita, 61, 587 
Glycerites, 61, 587 

of carbolic acid, 515 

boroglycerin, 507 

hydrastis, 268 

starch, 583, 589 

tannic acid, 182 

yolk of egg, 589 
Glyceritum acidi carbolici, 515 
tannici, 182 

amyli, 583, 589 

boroglycerin, 507 

hydrastis, 268 

vitelli, 589 
Glyceril, 587 
Glycil, 587 
Glycyrrhiza, 578 

glabra, 578 
Glycyrrhizin, 578 
Glycyrrhizinum amrnoniatum, 579 
Goa powder, 567 
Gold and sodium chloride, 453 
Golden seal, 265 



696 



INDEX. 



Gold and sodium chloride, 453 
Gondret's vesicating ointment, 561 
Gossypii radicis cortex, 275 
Gossypium herbaceum, action and uses of, 
275; oil of, 576 

purificaturn, 597 
Goulard's cerate, 195 

extract, 194 
Graminacese, 216, 269 
Gramineae, 269, 397, 399, 582, 590 
Granatum, 599 ; action and uses of, 605 
Granulated effervescing salts, 57 

salts, 57 
Granville's lotion, 561 
Gray powder, 446 
Green briar White Sulphur Springs, 340 

iodide of mercury, 454 
Green soap, 566 ; tincture of, 567 

vitriol, 431 
Griffith's antihectic mixture, 430 
Grindelia, 320 

robusta, 320 

squarrosa, 320 
Grindelin, 320 
Ground holly, 417 

Guaiac, action, preparations and uses of, 382 ; 
classed with emmenagogues, 423 

beta- resin, 383; resin, 382 

wood, 382 
Guaiaci lignum, 382 

resina, 382 
Guaiacol, in guaiac, 383 ; action and uses 
of, 518; in creosote, 516; use in 
phthisis, 517-18; hypo., 636 
Guaiacum officinale, 382 

sanctum, 3S2 
Guaiacum wood, 382 
Guarana, 141 
Gum arabic, 572 

Senegal, 573 

Turkey, 573 

varieties of, 572 
Gums, definition of, 50, 51 
Gum resins, 50, 51 
Gunjah, 111 
Guttiferae, 370 
Gypsum, 592 

Hagenia abyssinica, 606 
Haematein, 186 

Haematics, 81 ; action and division of, 429 
Hsematinics, 81, including only iron pre- 
parations, 427 
Haematoxylon, 186 

campechianum, 186 
Hamamelis, 188 

virginica, 188 
Hamamelaceae, 188, 421 
Hard petrolatum, 589 
Hashish, 111 
Heat, 32 

dry, action of, 34 



Heat, medicinal uses of, 33 

physiological effects of, 32 
Hebra's ointment, 196 (foot note) 
Hedeoma, 233 

pulegioides, 233 
Helix, 39 
Hellebore, American, 241 

swamp, 241 
Hemiptera, 599 
Hemlock, 287 
Hemp, Indian, 111 
Henbane, 106 
Herapathite, 156 
Herapath's test, 156 
Hevea, species of, 593 
Hexane, 519 
Hircin, 585 
Hisperidin, 231 
Hirudo decora, 27 

medicinalis, 27 
Hive syrup, 391 
Hoffman's anodyne, 142 
Holtz electrical machine, 37 
Homatropine, 104 

hydrobromate, 104 
Homburg Spring, Germany, 351 
Honey, 332, 591 
Honeys, 61 ; see also mel 
Hope's camphor mixture, 130 
Hops, 113 

infusion of, 114 
Hordeum distichum, 216 
Horehound, 233 
Hot-air bath, 34 
Hot bath, 33 

bottles, 33 

bricks, 33 

compresses, 33 

elastic bags, 33 

foot bath, 33 

hip or sitz, 33 

iron, 34 

water, 33 

injections of, 33 
Hot springs, 34 

Arkansas, 34 

Bath County, Virginia, 34 

Las Vegas, New Mexico, 34 
Humulus, 113 

lupulus, 113 
Hunyadi Janos Spring, Hungary, 352 
Huxham's tincture, 149 
Hydragogue cathartics, 361 ; as vermifuges, 

599; general action of, 331 
Hydrargyri chloridum corrosivum, 444; 
action and uses of, 451 ; as topical 
antiseptic, 501; as escharotic, 565; 
hypodermic solution of, 637 
chloridum mite as cathartic, 374, 444 ; 
action and uses of,449 ; 
as vermifuge, 606 

cyanidum, 444 ; action and uses of, 455 



INDEX. 



697 



Hydrargyri iodidum flavum, 444 ; action and 
uses of, 454; rubrum, 444; action 
and uses of, 455; as topical anti- 
septic, 503 
oxidum flavum, 444; action and uses 
of, 447 

rubrum, 444; action and uses of, 447 
prseparata, 439 ; effects of, 439; uses 

of, 442 
et sodii iodidum, hypodermic solution 

of, 637 
subsulphas flavus, 331, 444; action 
and uses of, 456 
Hydrargyrum, 439; ammoniatum, 444 
action and uses of, 456 
cum creta, 444 ; action and uses of, 446 
Hydrastine, 265, 267 
Hydrastininae hydrochloras, 267 
Hydrastis, 147 ; action and uses of, 265 

canadensis, 265 
Hydrochinone, 527 
Hydrogen peroxide, 502 
Hydrogenii peroxidum, 502 
Hydrophyllacese, 153 
Hydroquinone, chemistry of, 509; action 

of, 529 
Hydrous wool fat, 584 
Hygienic remedies, 25 
Hymenoptera, 585 
Hypoquebrachine, 322 
Hyoscine, 107; as mydriatic, 110; hypo- 
dermic solution of, 636 
hydrochlorate, 109 

hydrobromate, 109; hypodermic solu- 
tion of, 636 
Hyoscyaminae hydrobromas, 109 
hypodermic solution of, 636 
sulphas, 108 
Hyoscyamine, 107; with mydriatics, 110 
Hyoscyamus, 106 

niger, 106 
Hyphse, 270 
Hypnotics, 81 

Hypodermic application of medicines, 74 ; 
solutions of various remedies (See 

Appendix, 636) 
syringe, 74 
tablets, 74 
Hypophosphites and their preparations, 
478, 479 



Ice bag, 36 

bladder, 35 

cap, 35 

cracked, 37 
Ice, internal action of, 35-37 

water, 35, 37, 572; dyspepsia, 572 
bottle of, 37 
compress, 37 
Iceland moss, 580 
Ichthyocolla, 592; preparation and uses, 594 



Icthyol, 547 
Igasurine, 260 
Ilex paraguaiensis, 141 
Illicium, 234 

anisatum, 234 

verum, 274 
Imponderable remedies, 25 ; division of, 32 
Incompatibility of medicines, 54 
India rubber, 593 
Indian cannabis, 111 

poke, 241 

tobacco, 304 
Inflatin, 305 
Infusa, 58 

Infusions, 58 ; see also official titles of 
Infusum cinchonae, 161 

digitalis, 281 

picis liquidae, 409 

pruni Virginianse, 165 

sennse compositum, 359 
Ingluvin, 166 
Inhalant, 78 
Inhalation, 76 
Inhaler, steam, 78 

Injection, rectal, 79, 375; urethral, 80 
Ink, 180 
Inosit, 277 

Insecta, 556, 585, 599 
Instillation, 76 
Intillator, 76 
Inula, action and uses of, 426; Helenium, 

426 
Inulin, 247, 386, 397 
Inunction, 73 ; of mercury, 443, 446, 448 
Iodides of ammonium, sodium and potas- 
sium, 464 
Iodine, action and uses of, 458; baths, 462, 
hypodermic injection, (see Appen- 
dix, 637); as rubefacient, 455 
ointment, 462 ; preparations, 461-2 
Iodized collodion, 595 
Iodoform, 539 ; hypodermic solution of, 637 
Iodoformum, 539 
Iodol, 544 

Iodum, action and uses of, 458 ; as rube- 
facient, 555; (see iodine) 
Ioduretted potassium iodide, 462 
Ipecac, 324 
Ipecacuanha, 324 
Ipomcea jalapa, 361 

turpethum, 456 
Iridese, 366, 598 
Iridin, 367 
Iris, 366 

versicolor, 366 
Irish moss, 581 

Iron, effects, uses of and preparations, 427 ; 
and ammonium citrate, 436 ; tar- 
trate, 437 ; and potassium tartrate, 
434; and quinine citrate, 436, sol- 
uble, 436; and strychnine citrate 
436 



INDEX. 



Irritants, 81, subdivision of, 549 

Issues, 26, 28 

Itch-mite, situation and treatment of, 640 

Jaborandi, 378 

Taborin, 378 

Jalap, 361 

Jalapa, 361 

James' powder, 252 

Jamestown weed, 105 

Japaconine, 235 

Japaconitine, 235 

Jasmine, 315 ; Carolina or yellow, 315 

Jateorrhiza Calumba, 146 

Jerusalem oak, 602 

Jervine, 241 

Jordan's White Sulphur Springs, 340 

Juglandaceae, 355 

Juglans, 355 

cinerea, 355 
Juniper, 398 ; tree, French, 408 
Juniperus, action and uses of, 398 

communis, 398 

sabina, 423 

Virginiana, 424 
Jute, sublimated, 501 

Kairin, 510 
Kamala, 599 

action and uses of, 607 
Kelp, 458 

Kesselbrunnen springs, 491 
Kino, 185 

red, 185 
Kinoin, 185 

Kissingen Springs, Bavaria, 351 
Kochbrunnen, 351 
Koussin, 606 ; dose, 607 
Kousso, 606 
Krameria, 185 

ixina, 185 

triandra, 185 

Labarraque's liquid or fluid, 500 

Labile application, 40 

Labiatae, 133, 231, 386 

Lac sulphuris, 339 

Lactone, 232 

Lactosin, 402 

Lactuca virosa, 93 

Lactucarium, 93 

Lactucin, 94 

Ladies' slipper, 132 

Lady Webster pills, 357 

Lanolin, 584 

Lanthopine, 83 

Lappa, 386 

Lard, 584 

oil, 584 
Las Vegas Springs, 34 
Laudamine, 83 
Laudanum, 92 



Lartigue's gout pills, 394 (foot-note) 
Laurineae, 128, 224, 385 
Labiatae, 133, 231 
Lavements, 79 
Lavender, 231 
Lavandula, 231 

officinals, 231 
Laxatives, 331, 332 
Lead arthralgy, 192 

and its preparation, 191 

encephalopathy, 193 

paralysis, 192, 193 

plaster, 63, 196 

poisoning, 192, 196 

water, 194 

water and laudanum, 194 
Leamington Springs, England, 352 
Ledoyen's disinfecting fluid, 195 
Leeches, 27 

Le Clanche's battery, 38 
Leguminosse, 185, 186, 283, 290, 332, 

334, 357, 399, 410, 421, 567 
Lemon, 258 

juice, 259; oil, spirit or essence, 259 

peel, 259 
Lemonade, 259 
Leopard's bane, 246 
Leptandra, 359 
Leptandrin, 359 
Lethal, 585 
Lettuce, garden, 93 

opium, 93 
Leuk Springs, 496 
Levant worm seed, 603 
Leyden jar, 38 
Licebane, 248 
Lice, varieties, situation and treatment of, 

640 
Lichenes, 580 
Lichenin, 580 
Light, 32 

effects of, 32 
Lignum vitas, 382 
Liliaceae, 241, 244, 356, 381, 389, 391, 

403 
Lily of the valley, 285 
Lima bark, 154 
Lime, 494 

juice, 259 

liniment, 495 

solution, 494 

water, 494, enemata, 376 
Limonene, 231, 232, 395 
Limonis cortex, 259 
Limonis succus, 259 
Lineae, 135 

Liniment of ammonia, 218; as a rube- 
facient, 554 

belladonna, 104 

camphor, 130 

chloroform, 123 ; with rubefacients, 555 

lime, 495 ; application of, 575 



INDEX. 



699 



Liniment, mustard, compound, 553 
soap, 131 
soft soap, 556 
turpentine, 408 
volatile, 554 
Linimenta, 62 
Liniments, 62 

Linimentum ammoniae, 218, 576; as a 
rubefacient, 554 
belladonnas, 104 

calcis, 495 ; application, 575, 576 
camphorae, 130, 576 
cliloroformi, 123 ; with rubefacients, 

555 
plumbi subacetatis, 576 
saponis, 131 

mollis, 566 
sinapis compositum, 553 
terebinthinae, 408 
volatile, 554 
Linseed, 574 
ground, 575 
oil, 337 
tea, 575 
Lint, 576 

patent, 576 
sublimated, 502 
Linum, 574 

usitatissimum, 574 
Liquidambar orientalis, 421 
Liquid petrolatum, 589 
Liquids, 56, 58 
Liquor acidi arsenosi, 477 
ammonii acetatis, 256 
arsenii et hydrargyri iodidi, 477 
calcis, 494 

carbonis detergens, 408 
ferri acetatis, 435 
chloridi, 432 
citratis, 435 
Liquor ferri et ammonii acetatis, 434 
nitratis, 435 
subsulphatis, 432 
tersulphatis, 431 
gutta-perchae, 592; action and uses 

of, 593 
hydrargyri nitratis, 444; action and 

uses of, 457 ; as escharotic, 565 
iodi compositus, 461 
magnesii citratis, 345 
plumbi subacetatis, 194 

dilutus, 195 
potassae, 485 

potassii arsenitis, 475; hypodermic 
solution of, 636 
citratis, 256 
sodae, 487 

chloratae, 500 
sodii arsenatis, 477 

silicatis, 592; action and uses of, 
593 
zinci chloridi, 200 



Liquores, 58 

Liquors, alcoholic, strength of, various (see 

Appendix, 637 ) 
Liquorice, refined, 589 ; root, 578 

extract, 579 ; extract, pure, 580 
Litharge, 196 

Lithian mineral waters, 493 
Lithii benzoas, 492 

bromidum, 301 

carbonas, 492 

citras, 492 ; effervescens, 492 

prseparata, 492 

salicylas, 530 
Lithium preparations, effects and uses of, 492 

benzoate, 492 

bromide, 301 

carbonate, 492 

citrate and effervescent citrate, 492 

salicylate, 530 
Liver of sulphur, 339 
Lobelia, action and uses of, 304, 330 

inflate, 304 
Lobeliaceae, 304 
Lobeline, 305 
Local blood-letting, 27 
Local anaesthesia, 125 
Loganiaciae, 260, 600 
Loganin, 260 
Logwood, 186 

Londonderry Lithia Springs, 493 
London paste, 563 
Lotio flava, 448 

nigra, 448 
Lotion, 73 
Loxa bark, 155 
Lozenges, 58 ; uses of, 76 
Lugol's solution, 461 
Lunar caustic, 204 ; as escharotic, 562 

mitigated 204 
Lupulin, 113 
Lupulinum, 113 
Lupulite, 114 
Lux, 32 

Lycopodiaceae, 596 
Lycopodium, 596 ; action and uses, 596 

clavatum, 596 
Lysol, preparation, composition of, 519; 

effects and uses, 546 
Lythrariae, 605 
Lytta vesicatoria, 556 

Mace, 224 

Maceration, 59 

Macis, 224 

Magistery of bismuth, 205 

Magnesia, 343 

alba, 343 

calcined, 343 

ponderosa, 343 
Magnesii carbonas, 343 

citras effervescens, 345 

praeparata, as antacids, 493 



'00 



INDEX. 



Magnesii sulphas, 344 
Magnesium carbonate, 343 

preparations, as antacids, 493 

silicate (Talc), 596 

sulphate, 344 

sulphocarbolate, 516 
Magneto electricity, action of, 40 
Magnoliacex, 234 
Maisch's table, 66 
Male fern, 604 
Mallotus philippinensis, 607 
Malt, 216 
Malt extract, 216 

Liquors, 216 
Malvaceae, 275, 577 
Mammalia, 584, 585 
Mandrake, 363 

Manganese sulphate, as tonic, 169; as 
cathartic, 346 

dioxide, 169 
Mangani dioxidum, 169 

praeparata, 168 

sulphas, as tonic, 169; as cathartic 
346 
Manna, 333 

canulata, 333 
Mannit, 333, 359 
Marienbad Spring, Bohemia, 352 
Marigold, 385'- 
Marrubium, 233 

vulgare, 233 
Marsh's test for arsenic, 470 
Marshm allow, 577 
Martial preparations, 427 
Mass of ferrous carbonate, 430 
copaiba, 412 
mercury, 444 
Massa copaibae, 412 

ferri carbonatis, 430 

hydrargyri, as cathartic, 375; action 
and uses of, 444 
Massage, 32; kinds of, 46 

action and uses of, 47 

a friction, 46 
Mastic, 422 
Mastiche, action and uses of, 422; resin, 

422 
Masticin, 422 
Mate, 141 
Materia Medica, definition of, 25, 49 

animal, 50 

inorganic, 50 

organic, 50 
Matico, 415 
Matricaria, 151 

chamomilla, 151 
May apple, 363 
Meadow saffron, 391 

sweet, 527 
Mechanical remedies, 25, 26 
Meconin, 83 
Meconic acid, 83 ; test for opium, 85 



Meconidine, 83 
Medicated soaps, 566 

waters, 58 
Medicines, 49 

chemical decomposition of, 54, 55 

insolubility of, 54; incompatibility, 54 

physiological antagonism of, 54 
Mel, 591 

despumatum, 591 

rosse, 189 
Melaleuca leucadendron, 226 
Melissa, 386 

officinalis, 386 
Mellita, 61 

Menispermaceae, 146, 147, 268, 385, 415 
Menispermine, 268 
Menispermum, 385 

canadense, 385 
Mentha piperita, 231 

viridis, 231 
Menthol, action and uses of, 232 ; with 
antiseotics, 538; rubefacients, 555 
Menthone, 232 
Menthylene, 232 

Mercurial cathartics, 331 ; action and uses 
of, 374, 444 

ointment, 444; action and uses of, 
445 

plaster, 444 ; action and uses of, 446 
Mercurials as emmenagogues, 423 

by fumigation, 443, 451 

hypodermic injection, 443 (see Ap- 
pendix, 637) 

inunction, 443, 446, 448 
Mercuric chloride, corrosive, 444 ; action 
and uses of, 451 ; as topical anti- 
septic, 501 ; as escharotic, 565 

cyanide, 444; action and uses of, 455 

iodide, 444 ; action and uses of, 455 

nitrate, 457 
Mercurous chloride, mild, 444 ; action and 
uses of, 449 ; as cathartic, 374 ; as 
vermifuge, 606 

iodide, 444; action and uses of, 454; 
as antiseptic, 503 
Mercury, chlorides, 444 

iodides, 444 

metallic, 439, 444 

nitrates, 444 ; oxides, 444 

preparations of, 439 ; enumerated, 
444 ; effects of, 439 ; uses of, 442 ; 
with chalk, 444 ; action and uses 
of, 446 
Methal, 585 
Methylconine, 287 
Methylacetanilide, 522 
Methylene bichloride, 123 
Methyl-nonyl-ketone, 424 

salicylate, 230 
Methyl-theobromine, 133 
Metrical system of weights, 64 

compared with Troy weights, 65, 66, 67 



INDEX, 



701 



Mezereum, 383 

Michigan Congress Springs, 349 
Migranin, 648 
crid catl 
uses of, 353 
Milk, diet of, 611; peptonized and with rice , 
weed, 395 [610 

Minnequa Springs, Penna., 340 
Mineral acids, action and uses of, 169; as 
—escharotis, 566 
astringents, 191 
Mint, camphor, 232 
Mistura cretse, 495 

ferri composita, under myrrh, 419 

iron, 430 
glycyrrhizse, composita, 580 
rhei et sodae, 355 
Misturse, 58 

Mitchell Weir, treatment, 48 
Mixtures, 58 
Mocassin plant, 132 
Modus operandi of medicines, 52 
Molasses as laxative, 332 ; properties and 

action of, 590, 591 
Monkshood, 235 
Monobromated camphor, 131 
Monsel's solution, 432 
Morphina, 83 
Morphinae acetas, 92 
hydrochloras, 93 
sulphas, 92 

hypodermic solution of, 637 
Morphine, 83 
Morrhuol, 467 
Morson's aconitine, 236 
Mortar, 56 
Moschus, 141 

moschiferus, 141 
Mouth and throat, applications of medi- 
cines to, 76 
Mucilage, 573; acacia, 573; elm, 577; 
sassafras pith, 577 ; tragacanth, 574 
Mucilago acaciae, 573 

sassafras medullse, 577 
tragathanthae, 574 
ulmi, 577 
Mucous membranes, application of medi- 
cines to, 73, 75 
gastro -intestinal, application of medi- 
cines to, 79 
tracheo-bronchial, application of med- 
icines to, 76 
urino-genital, 79 

vagino -uterine, application of medi- 
cines to, 79 
Muscarine, 110 
Musk, 141 

deer, 141 
Mustard, as emetic, 330; action and uses 
of, 550 
black and white, 550 
whey, 553 



Mutton-suet, 585 
Mycelium, 270 
Mydriatic alkaloids, 110 
Myotic alkaloids, 110 
Myrdia acris, 216 
Myristica, 224 

fragrans, 224 
Myristicacese, 224 
Mynsticin, 225 
Myristicol, 225 
Myrosin, 552 
Myroxylon Pereirse, 421 
Myrrh, 419 
Myrrha, action and uses of, 419 ; as em- 

menagogue, 423 
Myrtaceae, 149, 226 

Naphthalin, chemistry of, 509; action and 

uses of, 533 
Naphthalinum, 533 
Naphtol, 534 
Narceine, 83, 84 
Narcotics, 81 
Narcotine, 83, 84 
Nasal douche, 75 ■ 
Nasal mucous membrane, application of 

medicine to, 75 
Nasrol, 649 
Natron, 487 
Nauseants, 322 
Negative plate, 41 ; pole, 39 
Neroiol, 231 
Nerolyl acetate, 231 
Neurotics, 81 
New Almaden vichy, 437 
Nicotine, as myotic, 110 ; in tobacco, 303 
Nicotianin, 303 
Nicotiana tabacum, 302 
Nitre, 253 

cubic, 255 
Nitro-benzine, chemistry of, 509 ; poisoning 

by, 519 
Nitro-glycerin, 313 
Nitro-glycerinum, 313 
Nitrous oxide gas, 124 
Nitrous powders, 255 
Normal quinine sulphate, 162 

ferric sulphate, 431 
Norway spruce, 554 
Nucin, 350 
Nutgall, 183 
Nutmeg, 224 
Nux vomica, 260 

Oak, Jerusalem, 602 

red, 187 

white, 186 
Oakum, 576 
Ocular therapy, 103 
Official, definition of term, 50 
Officium, 50 
Oil, bitter almond, 310 



'02 



INDEX. 



Oil, benne, 578 

bergamot, 234 

betula, volatile, 230 

cade, 408, 410 

camphor, 129 

castor, 334 

chenopodium, 602 ; dose, 603 

cloves, 226 ; as antiseptic, 538 

cod-liver, 466 

copaiba, 410 ; dose of, 412 

cotton seed, 576 

cubeb, 412 ; dose of, 413 

erigeron, 395 

essential, definition of, 51 ; action and 
uses of, 221 ; as antiseptic, 538 

fennel, 234 

fixed, definition of, 50, 51 

garlic, 403 

gaultheria, 230; as antiseptic, 538 

juniper, 398 

lard, 584 

lemon, 259 

linseed, 337, 575 

mustard, 553 

neroli, 231 

nutmeg, 225 

olive, 334 ; parsley, 426 

peppermint, 232; with antiseptics, 538 

rose, 190 

rue, 424-5 

santal wood, action and uses of, 414 

sassafras, 386 

savine, 424 

styrol, 421 

tansy, 425; dose of, 426 

theobroma, 134; action andusesof, 586 

thyme, 233 ; with antiseptics, 538 

turpentine, 405; rectified, 405; action 
and uses of both, 406; enemata, 
376 ; as a rubefacient, 553 ; as ver- 
micide, 599, 606 

volatile, definition of, 50, 51; action 
and uses of, 221 

wine, 142 

wintergreen, 230 
Oil-cake, 576 
Oil of Vil 
Ohm, 40 
Ointment, 584 (for official, see unguentum) 

ammoniated mercury, 444, 456 

antimonial, 561 

belladonna, 104 

carbolic acid, 515 

chrysarobin, 568 

diachylon, 196 

gallic acid, 182 

galls, 184 

iodine, 462 

iodoform, 542 

lead carbonate, 196; iodide, 195 

mercuric nitrate, 444; uses of, 457 

mercurial, 444; uses of, 445 



Ointment, potassium iodide, 465 

red mercuric oxide, 444, 447 

stramonium, 106 

sulphur, 339 

tannic acid, 182 

tar, 408, 410 

veratrine, 245 

yellow mercuric oxide, 444, 448 

zinc oxide, 199 
Ointments, 62 
Olea europeea, 334 

volatila, 221 
Oleaceae, 333, 334 
Oleata, 53 
Oleate of bismuth, 206 

copper, 198 

mercury, 444 ; action and uses of, 448 

veratrine, 246 

zinc, 200 
Oleates, 63 

Oleatum hydrargyri, 444 ; action and uses 
of, 448 ; veratrinae, 246 ; zinci, 200 
Oleic acid, 585 
Olein, 576, 585 
Oleoresina aspidii, 605 

capsici, 223 

copaibae, 410 

cubebae, 413 

lupuli, 114 

piperis, 223 
Oleoresinae, 61 
Oleoresins, 61 

definition of, 50, 51, 61 
Oleum adipis, 584 

gethereum, 142 

amygdalae am arse, 310 

expressum, 311 ; as cathartic, 334 

anisi, 234 

aurantii corticis, 231 
florum, 231 

bergamottae, 234 

betulse volatile, 230 

cadini, 408; exhibition of, 410 

cajuputi, 226 

cari, 234 

caryophylli, 226 

chenopodii, 602, dose of, 603 

cinnamomi, 224 

copaibas, 410; dose of, 412 

coriandri, 234 

cubebae, 412 ; dose of, 413 

erigerontis, 395 

eucalypti, 150 

fceniculi, 234 

gaultheriae, 229, 230, 538 

gossypii ieminis, 576 

hedeomae, 233 

juniperi, 398 

lavandulae florum, 231 

limonis, 259 

lini, as cathartic, 337; action and uses 
of, 575 



INDEX. 



703 



Oleum menthse piperita, 232, 538 
viridis, 232 

morrhuse, 466 

myrcise (distilled from myrcia acris, 
216) 

myristicse, 225 

olivae, 334 

phosphoratum, 179 

picis liquidae, 408; dose of, 410 

pimentae, 226 

ricini, 334 

rosse, 190 

rosmarini, 231 

rutse, 424; effects and uses of, 425 

sabinse, 424 

santali, 414 

sassafras, 386 

sesami, 578 

sinapis volatile, 553 

terebinthinse, action and uses of, 406; 
enemata, 376 ; as a rubefacient, 553 ; 
as vermicide, 599, 606 

rectificatum, 406 

theobromatis, 586 

thymi, 233 

tiglii, action and uses of, 372; as 
suppurant, 561 
Olive oil, 334 
Opii pulvis, 91 
Opium, 82 

alkaloids of, 83 

antidotes to, 87 

constituents and tests, 83 

deodoratum, 91 

medicinal uses, 88 

physiological effects, 85 

plaster, 92 

poppy, 82 

smoking, 87 

tincture of, 92 

deodorized, 92 

toxicology, 86 

vinegar of, 92 

wine of, 92 
Orange, 230 ; preparations of, 231 

bitter and sweet, 230 

water, 231 

stronger, 231 
Orchidaceae, 132, 234 
Ordeal bean of calabar, 290 
Orexine hydrochloride, 648 
Ounce, 63 
Ovis aries, 585 
Oxgall, 167 

Pachydermata, 584 
Painters' colic, 192 
Pale bark, 155 
Palma christi, 334 
Palmitin, 336, 576, 585 
Pancreatin, 167 
Pancreatinum, 167 



Papain, 167 

Papaver, 82 ; somniferum, 82 
Papaveracese, 82, 327, 366 
Papaverine, 83, 84 
Papaya, 167 
Papayacese, 167 
Papers, 58 
Paraffine, 589 
Paraguay tea, 141 
Paraldehyde, 94 
Peraldehydum, 94 
Parallin, 381 
Paramenispermin, 268 
Paramorphine, 83, 84 
Para rubber, 593 
Parasites, intestinal, 642 

skin, 638 
Parasitic insects, dermal, 640-1 
Paregoric, 92 
Pareira, action and use of, 415 

Brava, 415 
Paris Green, 473 
Parsley camphor, 426 
Partridge berry, 229 

Parts to which medicines are applied, 73 
Pasque flower, 246 
Paullinia sorbilis, 141 

cupan'a, 141 
Pearl white, 205 

Pectin, definition of, 50 and 52; 277 
Pedaliacese, 578 
Pelletierine, 605 

tannate, 605 
Pennyroyal, 233 
Pentane, 519 

Pepo, 599; action and uses of, 607 
Pepper, action and uses of, 223; as rube- 
facient, 555 

black,. 223 

cayenne, 222 

white, 223 
Peppermint, 231 

water, 233 
Pepsin, 165 
Pepsinum, 165 

saccharatum, 166 
Percolation, 59 
Percolator, 59 
Peroxide of hydrogen, 502 
Pestle, 56 
Petrissage, 46 
Petrolatum, 62; action and uses of, 589 

liquidum, 589 

molle, 589, 590 

spissum, 589 
Petroselinum sativum, 426 
Phseortin, 354 

Pharmacological remedies, 25; defined, 49 
Pharmacology, 49 
Pharmacopoeia of the U. S.,49 
Phenol, chemistry of, 509; action and uses 
of, 510 ; in creosote, 516 



704 



INDEX. 



Pharmacy, definition of, 4 9 
Phellandrene, 232 
Phenacetine, 538 
Phenocoll hydrochloride, 539 
Phenvl, 508; chemistry of, 508; hydrate, 
510 

hydride, chemistry of, 508 ; poisoning 
by, 510 
Phlebotomy, 26 
Phormine, 83 
Phosphorus, 176 
Physeter macrocephalus, 585 
Physostigma, 290 * 

venenosum, 290 
Physostigminae salicylas, 292 

sulphas, 292 
Physostigmine, 290 
Phytolacca, 247 

decandra, 247 
Phytolaccaceae, 247 
Phytolaccin, 248 
Picraconitine, 235 
Picraena excelsa, 144 
Picropodophyllin, 363-5 
Picrosclerotin, 272 
Picrotoxin, 268, 269 
Picrotoxinum, 268 
Pills, 57 (see also pilulae) 

compressed, 57 

gelatin coated, 57 
Pilocarpine, as myotic, 110; action and 
uses of, 378 

hydrochlorate, 380; hypodermic solu- 
tion of, 637 
Pilocarpus, 378 

jaborandi, 378 

selloanus, 378 
Pilulae, 57 ; aloes, 357 

aloes et asafoetidae, 127, 357 

ferri, 357 

mastiches, 357 ; uses of, 422 

myrrhae, 357 ; uses of, 419 

antimonii compositae, 252 

asafoetidae, 127 

catharticae compositae, 371 
vegetabiles, 370 

ferri carbonatis, 430 

iodidi, 434 

opii, 91 

phosphori, 179 

rhei, 355 

compositae, 355 
Pimenta, 226; officinalis, 226 
Pimpinella anisum, 234 
Pine, long-leaved, 404; pitch and yellow, 

404 
Pinene, 225, 232, 424 
Pinkroot, 600 
Pint, 65 
Pinus australis, 404 ; palustris, 408 

taeda, 405 



Piper, 223 

angustifolium, 415 

cubebae, 412 

nigrum, 223 
Piperaceae, 223, 412, 415 
Piperazine, 649 
Piperine, 223 
Piperinum, 223 
Pipsissewa, 417 
Pisces, 446, 594 
Pistacia lenticus, 422 
Pitch, 408 

Pituitary membrane, 75 
Pix Burgundica, 554 

liquida, action, preparations and uses 
of, 408 

mineralis, 448 
Plasma, 583 
Plaster, adhesive rubber, 594 

ammoniac with mercury, 128, 446 

arnica, 247 

belladonna, 104 

burgundy pitch, 554 

cantharidal pitch, 554 

capsicum, 223 

iron, 430 

isinglass, 594 

lead, 196 

mercurial, 446, 

opium, 92 

Paris, bandage, 592 

resin, 594 

soap, 196 

spice, 555 

warming, 555 
Plasters, 63 ; see also emplastrum. 
Pleurisy root, 386 
Plumbi acetas, 193 

carbonas, 196 

iodidum, 195 

nitras, 195 

oxidum, 196 
Plumbi praeparata, 191 
Plummer's pills, 252 
Pneumatic aspiration, 29 
Podophyllin, 365 
Podophyllum, 363 

peltatum, 363 
Poison-ivy, 268 
Poison-nut, 260 
Pokeberries, 247 

Indian, 241 

root, 241-7 
Poland Spring, 490 
Polarity, 39 

Poles, 41 ; positive and negative, 39 
Polycroit, 599 
Polygala senega, 400 
Polygaleae, 185, 400 
Polygon aceae, 189 
Pomegranate, 605 



INDEX. 



705 



Poppy, black, 82; capsule, 82; 

white, 82 
Porifera, 598 
Porte-caustic, 76 
Porter, 216 

Positive plate, 41 ; pole, 39 
Potassa, 562 

cum cake, 563 
sulphurata, 339 
with lime, 563 
Potassii acetas, 388 
bicarbonas, 486 
bichromas, action and uses of, 482 ; as 

escharotic, 565 
bitartras, 347 
bromidum, 296 
carbonas, 485 
chloras, 480 
citras, 255 

effervescens, 256 
cyanidum, 310 
et sodii tartras, 348 
ferrocyanidum, 307 
hypophosphis, 479 
iodidum, 462 ; hypo- of, 637 
nitras, 253 
permanganas, action and uses; 498, as 

emmenagogue, 423 
praeparata, physiological effects of, 253 ; 

as antacids, 484 
sulphas, 347 
Potassium acetate, 388 

and sodium tartrate, 348 
bicarbonate, 484; effects and uses of, 
486; carbonate, 484; effects and 
uses of, 485 
bichromate, action and uses of, 482; 

escharotic, 565 
bitartrate, 347 
bromide, 296 
chlorate, 480 
citrate, 255 

effervescent, 256 
cyanide, 310 
ferrocyanide, 307 
hypophosphite, 479 
iodide, 462 ; hypodermic of, 637 
nitrate, 253 ; papers of, 255 
nitrite, 315 
permanganate, 169 ; action and uses, 

498 ; as emmenagogue, 423 
preparations, 253 ; as antacids, 484 
sulphate, 347 
sulphocarbolate, *516 
Potatoe flies, 560 

Poultices, 33, 63; action and uses of, 570 
charcoal, 571 
laudanum. 571 

linseed, action of, 570 ; preparation, 575 
medicated, 571 
mustard, 552 ; preparation of, 575 

45 



Poultices, rubefacient, 552 

starch, 583; yeast, 571 
Pound, 63 

Powders, 56 (see pulvis for official) 
Precipitated calcium phosphate, 478 ; car- 
bonate, 496 
sulphur, 339 
Prickly ash, 384 
Precipitation, 56 
Preparations, arsenic, 469 

iron, as emmenagogues, 423; effects 
of and Pharmacopoeial preparations, 
427 
potassium, 484 
Prepared chalk, 495 
Prescription writing, 67 
Propenyl, 587 
Propyl, 403 
Protectants and absorbents, 81 ; action and 

classification of, 592 
Protozoa, 598 
Prune, 332 
Prunum, 332 
Prunus serotina, 165 
Virginiana, 165 
Prussic acid, 307 
Prussian Blue, 307 
Pseudaconine, 235 
Pseudaconitine, 235 
Pseudojervine, 241 
Pseudomorphine, 83 
Pseudotropine, 107 
Pterocarpin, 599 
Pterocarpus marsupium, 185 

santalinus, 599 
Pulegone, 233 

Pullna Spring, Bohemia, 352 
Pulsatilla, 246 
Pulveres, 56 
Pulvis antimonialis, 252 
aromaticus, 228 
cretse compositus, 495 
effervescens compositus, 348 
glycyrrhizse compositus, 339 ; use, 359 
ipecacuanhse et opii, with opium, 92, 

327 
jalapse compositus, 362 
morphinse compositus, 93 
rhei compositus, 355 
Pumpkin, 607; seed, 607 
Punica granatum, 605 
Purgatives, 331 ; saline, 341 ; 

hydragogue, 361 
Purging cassia, 333 
Purified animal charcoal, 597 
Purple foxglove, 276 
Pyrethrum, 422 
Pyridine, 509 
Pyrmont Spring, 438 
Pyrocatechin, in kino, 185 ; chemistry of, 

509 ; action of, 527 
Pyrogallol, 568 



706 



INDEX. 



Pyrol, or tetra-iodol-pyrol, 544 

Pyroxylin, 595 

Pyroxylinum, 59- ; chemistry of, 595 

Quassia, 144 
Quassin, 145 
Quebrachamine, 322 
Queen's root, 386 
Quercitrin, 184 
Quercus alba, 186 

lusitanica, 183 
Quevenne's iron, 429 
Quicksilver, 439 
Quillaja, 402 

saponaria, 402 
Quinicine, 155 
Quinidinse sulphas, 164 
Quinidine, 156 

commercial, 156 
Quinina, 155 
• Quininse bisulphas, 162, 163 ; hypodermic 
solution of, 637 

hydrobromas, 163 

hydrochloras, 163 

sulphas, chemistry of, 155, 162 ; 
action of, 156; uses of, 158 ; dose of, 
162 

valerianas, 163 
Quinine, 155 ; hypodermic solution of, 637 
salts, therapeutic equivalents of, 
162 

bisulphate, 162, 163 

carbolate, 163 

citrate, 163 

crude, 163 

hydrobromate, 163 

phosphate, 163 

sulphate, chemistry of, 155, 162; 
action of, 156 ; uses of, 158 ; dose 
of, 162 

sulphocarbolate, 163 

sulphovinate, 163 

valerianate, 163 
Quinocine, 510 

Ragoczi spring, 351 

Ranunculaceae, 147, 235, 246, 248, 265, 

281, 285. 
Rapsberry, 190 
Rawley Springs, 437 
Reaction of degeneration, 41 
Rectum, as receptacle of medicines, 79 
Red bark, 154 
cedar, 424 
mercuric oxide, 444 ; action and uses 

of, 447 ; iodide, 444 ; action and uses 

of, 455 ; as topical antiseptic, 503 
Saunders, 599 
Reduced iron, 429 
Refrigerants, 235 ; action and uses of, 255, 

388 
Reinsch's test for arsenic, 470 



Remedies, list of new, 647 
Resin, 405, 592; action and uses of, 594 ; 
of copaiba, 410; of cubeb, 413; of 
mastic, 422 ; cerate, 544 :, plaster, 
594 ; definition of, 50, 51 
Resina and its preparations, 592 ; action 
and uses, 594 

copaibae, 410; and table of doses, 621 

jalapse, 362 

podophylli, 365 

scammonii, 369 
Resorcin, 127; chemistry of, 509 ; action 

and uses of, 525 
Resorcinum, 525 
Retin, 373 
Rhamnaceae, 360 
Rhamneae, 359 
Rhamnus frangula, 359 

Purshiana, 369 
Rhatanic red, 185 
Rhatany, 185 
Rheophore, 41 
Rheostat, 41 
Rheotome, 39 

Rhigolene, 35; action and uses of, 125 
Rheum, 353 

officinale, 353 
Rhubarb, 353 

Chinese, 353 

European, 353 

Russian, 353 
Rhus glabra, 190 

radicans, 268 

toxicodendron, 268 
Richfield Springs, N. Y., 340 
Ricinine, 336 
Ricinolein, 336 
Ricinus communis, 334 
Ringworm, varieties, symptoms and treat- 
ment of, 638 
Rochelle salt, 348 
Rockbridge alum springs, 209 
Rock-candy, 590 
Rosa centifolia, 189 

gallica, 189 
Rosacea?, 165, 189, 190, 310, 402, 606 
Rose water, 189 

stronger, 189 
Rosin, 594 
Rottlera, 607 
Rottlerin, 607 
Rough on rats, 473 
Rubber adhesive plaster, 592 ; dimensions 

of, 594 
Rubefacients, 549 ; action and uses of, 550 
Rubiaceae, 154, 133, 324 
Rubijervine, 241 
Rubus, 190 

canadensis, 190 

idaeus, 190 

trivialis, 190 

villosus, 190 



INDEX. 



707 



Rufus' pills, 357 

Rules for converting Troy weight into 
grams, 64 

apothecaries' measure into cubic cen- 
timeters, 65 
Rum, 216 
Rumex, 189 

crispus, 189 
Ruminantia, 585 
Rumicin, 189 

Rutacese, 234, 259, 378, 384, 416, 424 
Ruta graveolens, 424 
Rye, 269 

Sabina, action and uses of, 423 
Saccharated ferrous carbonate, 430 ; fer- 
rous iodide, 434 
Saccharin, 591 
Saccharum, 590 

lactis, 591 

omcinarum, 590 

Saturni, 193 
Saffranin, 599 
Saffron, 598 
Sage, 233 

Saint Moritz Spring, 438 
Sal ammoniac, 219 

diureticus, 388 
Salicaceae, 164 
Salicin, 164 
Salicinum, 164 
Salicylates, 530 
Salicylic acid, 527 
Saline cathartics, 331 ; action of, 341 

mineral waters, N. American, 349 
European, 351 

refrigerants, 388 
Salipyrin, 538 
Salix, 164 

alba, 164 
Salol, 531 
Salophen, 534 
Salt of Riverius, 255 

petre, 253 

of tartar, 485 
Salvia, 233 

officinalis, 233 
Sambucus, 400 

canadensis, 400 
Sanguinaria, 327 

canadensis, 327 
Sanguinarine, 328 
Sanguisuga officinalis, 27 
Santal, 599 
Santalaceae, 414 

Santalum album, 414 ; rubrum, 599 
Santonica, 599 ; action and uses of, 603 
Santonin, 603 
Santoninum, 603 
Sapindaceae, 141 
Sapo, 566. 

durus, 566 



Sapo mollis, 566 

viridis, 566 
Saponification, chemistry of, 51, 587 
Saponin, 359, 381, 401, 402, 426 
Sapotoxin, 402 

Saratoga waters, uses of, 349 ; containing 
lithium, 493 

analysis of, 350 

effects and uses of, 349 
Sarsaparilla, 381 

varieties of, 381 
Sarsaponin, 381 
Sassafras, action and uses of, 385 

medulla, action and uses of, 577 

officinale, 577 

variifolium, 385 
Savine, 423 

Saw- dust, sublimated, 501 
Scabies, 640 
Scammonin, 368 
Scammonium, 368 
Scammony, 368 
Scarifications, 28 

Schooley's mountain springs, 437 
Schwalbach spring, 438 
Schuyler chalybeate spring, 437 
Scilla, action, preparations and uses of, 

389 ; as diuretic, 404 
Scillain, 390 
Scillin, 390 
Scillipicrin, 390 
Scillitoxin, 390 
Scitamineae, 226, 227 
Sclererytherin, 272 
Sclerocrystallin, 272 
Scleroiodin, 272 
Scleromucin, 272 

Sclerotium of claviceps purpurea, 269 
Scleroxanthin, 272 
Scoparin, 399 
Scoparius, 399 
Scrophulariaceae, 276, 359 
Scruple, 63 

Scudamore's colchicum draught, 394 
Scutellaria, 133 

laterifolia, 133 
Secale cereale, 269 
Sedatives, 81 ; general action of, 235 ; as 

diuretics, 388 
Seidlitz powder, 259 ; composition of, 348 
Seltzer Spring, Duchy of Nassau. 352 

water, 352 
Semi- solids, 56 ; list of, 62 
Senega, action and uses of, 400 ; as em- 

menagogue, 423 
Senega snake root, 400 
Senegin, 401 
Senna, 357 

Alexandria, 358 

India, 358 
Sennacrol, 358 
Sennit, 358 



708 



INDEX. 



Serous membranes, application of medicines 

to, 73. SO 
Serpentaria, 148 
Sesamum indicum, 578 
Setacea, 28 
Setons, 26, 28 
Sevuxn, 585 
Sharon Springs, New York, analysis of, 

340; containing iron, 437 
Sherry with egg, 609 
Signs and abbreviations, 612 
Silica bandage, 593 
Silver preparations, 201 

nitrate, 201 ; as escharotic, 562 
Simarubeae, 144 
Simple syrup, 61 
Sinalbin, 554 
Sinapine sulphate, 552 
Sinapis, as emetic, 330 ; action and uses of, 
550 
alba, 330 
nigra, 330 
Sinigrin, 551 

Skin, application of medicines to, 73 
Skullcap, 133 
Slippery elm, 576 

bark, 576 
Sloe, 318 

Smelling salts, 221 
Smilax, botanical varieties of, 381 
Snakeroot, Virginia, 148 
Soap bark, 402 
castile, 566 
hard, 566 
green, 566 

tincture of, 567 
liniment, 131 
medicated, 566 
plaster, 196 
soft, 566 

liniment of, 566 
Unna's, 566 
Socaloin, 356 
Soda, 563 

caustic, 563 
Sodii acetas, 388 
arsenas, 476 
benzoas, 524 
bicarbonas, 488 
bisulphis, 504 
boras, 507 
bromidum, 301 
carbonas, 487 

exsiccatus, 488 
chloras, 481 
hypophosphis, 479 
hyposulphis, 504 
iodidum, 465 
nitras, 255 
nitris, 315 
phosphas, 346 
prseparata, 487 



Sodii pyrophosphas, 347 

salicylas, 530 

sulphas, 345 

sulphis, 504 

sulpho-carbolas, 515 
Sodium acetate, 388 

arsenate, 476 

benzoate, 524 

bicarbonate 488 

bisulphite, 504 

borate, 507 

bromide, 301 

carbonate. 487 ; dried, 488 

chlorate, 481 

chloride, 173 

hypophosphite, 479 ; hyposulphite, ac- 
tion and uses of, 504 

iodide, 465 

nitrate, 255 

nitrite, 315 

phosphate, 346 

preparations, 487 

pyrophosphate, 347 

salicylate, 530 

sulphate, 345 

sulphite, 504 

sulpho carbolate, 515 
Soft petrolatum, 589 

Solanaces, 98, 105, 106, 109, 114, 222, 302 
Solanine, 114 
Solanum Dulcamara, 114 
Solids, 56 

Soluble ferric phosphate, 434; pyrophos- 
phate, 435 

gun cotton, 595 

glass, 593 
Solubility of medicines, 54 
Solution, ammonium acetate, 256 

arsenic and mercuric iodide, 477 

arsenous acid, 477 

ferric tersulphate, 431 ; ferric subsul- 
phate, 432 ; ferric chloride, 432 ; 
ferric citrate, 435 

gutta-percha, 593 

hydrogen peroxide, 503 

iodine, compound, 461 

iron and ammonium acetate, 434 

magnesium citrate, 345 

mercuric nitrate, 444 ; action and uses 
of, 457 ; as escharotic, 565 

potassa, 484 ; action and uses of, 4S5 

potassium arsenite, 475 

citrate, 256 
soda, 487 ; chlorinated, 500 

sodium arsenate, 477 

silicate, or soluble glass, 593 
zinc chloride, 200 
Solutions, 58 ; hypodermic, 636 
Soporifics, 81 
Soup, nourishing, 610 
Spa Spring, 438 
Spanish fly, 556 



INDEX. 



709 



Sparteine, action and uses of, 283; consti- 
tuent of scoparine, 399 
Sparteinse sulphas, 284 
Spastics, 259 
Special diuretics, 389 
Spearmint, 231 

water, 233 
Spermaceti, 585 

cerate, 585 

whale, 585 
Spice plaster, 555 
Spigelia, 599 ; action and uses of, 600 

marilandica, 600 
Spinants, 81 ; definition and division of, 259 
Spiraea ulmaria, 527 
Spirits, 60, various official, see spiritus 
Spiritus, 60 

aetheris compositus, 142 
nitrosi, 256 

ammonias, 218 

aromaticus, 219 

amygdalae amarae, 311 

anisi, 234 

aurantii, 231 

compositus, 231 

camphorae, 130 

chloroformi, 123 

cinnamomi, 224 

frumenti, 216 

gaultheriae, 230 

glonoini, 314 

juniperi, 398 

compositus, 398 

lavandulae, 231 

limonis, 259 

menthae piperitae, 233 
viridis, 233 ' 

mindereri, 256 

myrcise, 216 

myristicae, 225 

phosphori, 179 

sacchari, 216 

vini gallici, 216 
Sponge, 592 ; action and uses of, 598 
Sponge -holder, 76 

tent, 598 
Spongia, 598 
Spray, 76, 77 
Sprudel water, 491 
Squill, 330; action, preparations and uses 

of, 389 
Squirting cucumber, 371 
St. Catherine's Wells, Canada, 349 
St. Louis Spring, 489 
Stabile application, 40 
Staphisagria, 248 
Staphisain, 248 

Starch, 50, 52 ; action and uses of, 583 
Stav£sacre, 248 
Steam atomizer, 78 
Stearic acid, 586 
Stearin, 585, 586 



Stearoptens, 52 

Sterculiaceae, 586 

Sternberg's treatment of yellow fever, 489 

Sternutatories, 76 

Stethal, 585 

Stillbene, 421 

Stillingia, 386 

sylvatica, 386 
Stimulants, 81 ; action and uses of, 209 

diffusible, 210 
Stimulating diaphoretics, 378 
Stomach as receptacle of medicines, 79 
Stomach pump, 26 ; uses of, 31 
Storax, 421 
Storesin, 421 
Stramonium, 105 
Strontii bromidum, 301 

iodidum, 465 

lactas, 176 
Strontium bromide, 301 

iodide, 465 

lactate, 176 
Strophanthus, 282 

hispidus, 282 
Strychnina, 260; effects of, 265 
Strychninae sulphas, 265 
Strychnine, 260 ; effects of, 265 
Strychnos mix vomica, 260 

toxifera, 317 
Sturgeon, 594 
Sturiones, 594 
Styptic cotton, 432; collodion, 432; uses 

of, 596 
Styraceae, 419 
Styrax, action and uses of, 421 

benzoin, 419 
Styrol, 421 
Sublimation, 56 
Subsulphate of mercury, yellow, emetic, 

331 ; uses, 456 
Succedaneum, 49 
Sudorifics, 377 
Sugar, 590 

barley, 590 

beet, 590 

cane, 590 

grape, 590 

of lead, 194 
milk, 591 

raw, 590 

refined, 590 
Sulphaminol, 649 

Sulphides, action and uses of, 339 ; as an- 
tiseptics, 505 
Sulphonal, 96 
Sulphur, 337 

crude, 337 

disinfectant as, 338 

flowers of, 337 

iodide, 465 

lotum, 337 

praecipitatum, 339 



710 



INDEX. 



Sulphur soap, 339 

sublimatum, 337 

washed, 337 

waters, European, 340 

medicinal uses of, 341 
North American, 340 
Sulphurated lime, 505 

potassa, 339 
Sulphuretted hydrogen, effects of, 340 
Sulphuric acid, 170 
Sulphuris iodidum, 465 
Sulphurous acid, 503 
Sumach, 190 
Sumbul, 321 

Summit Soda Springs, 572 
Suppositoria, 62 

glycerini, 589 
Suppositories, preparation, kinds, and uses 

of, 62, 79, 587 
Suppurants, 549, 550 ; action and uses of, 

561 
Sus scrofa, 584 
Swedish movement cure, 48 
Swamp hellebore, 241 
Sweet flag, 228 

orange, 230 
peel, 230 

spirit of nitre, 256 
Sydenham's laudanum, 92 
Symphorol, 649 
Syringe, 76 
Syrup of poppy capsule, 82 

simple, 61 

various official, see syrupus 
Syrupi, 61 
Syrups, 61 

medicated, 61 
Syrupus, 61 

acaciae, 573 

acidi citrici, 259 
hydriodici, 466 

allii, 404 

altheae, 578 

amygdalae, 311 

aurantii, 231 
florum, 231 

calcii lactophosphatis, 176 ; composi- 
tion of, 478 

calcis, 495 

ferri iodidi, 434 

quininae et strychninae phospha- 
tum, 436 

fuscus, 591 

hypophosphitum, 479 

cum ferro, 479 

ipecacuanha?, 327 

krameriae, 186 

lactucarii, 94 

picis liquidae, 409 

pruni virginianae, 165 

rhei, 355 



Syrupus rhei aromaticus, 355 
rosae, 189 
rubi, 190 

idaei, 190 
sarsaparillae compositus, 382 
scillae, 391 

compositus, 391 
senegae, 402 
sennae, 359 
tolutanus, 422 
zingiberis, 227 



Tabacum,302 

Table for converting c. c. into f£, 67 

apothecaries' weights and measures 
into grain weights (Maisch's), 66 

of decimal with troy weights, compar- 
ative, 65 

of doses for adults, 615 

of parasites, 638 
Tablespoon, 65 
Tablet triturates, 56 

Taeniae, varieties and treatment of, 642-3-5 
Taffetas, vesicating, 560 
Talc, 592 ; uses of, 596 
Tamarind, 332 
Tamarindus, 332 

indica, 332 
Tampon, cotton, 598 ; sponge, 598 
Tanacetin, 425 

Tanacetum, action and uses of, 425 ; prep- 
arations of, 426 

vulgare, 425 
Tannic acid, 180 
Tansy, 425 

Tape-worm, varieties and treatment of, 642 
Tapotement, 46 
Taraxacerin, 397 
Taraxacin, 397 
Taraxacum, actions and uses of, 396 

dens-leonis, 396 
Tar, 408; water, 409; oil of, 408, 410 
Tartar, crude cream of, 259 
Tartar emetic, action and use of, 249; 

as emetic, 331 
Tartaric acid, 259 
Tate Epsom Springs, 496 
Tea, 133 

worm, 601 
Teaberry, 229 
Teacup, 65 
Teaspoon, <do 
Teleostia, 466 
Tent, sponge, 598 
Terebene, 408 

Terebinthina, action, preparations and uses 
of, 404 , 

canadensis, 405 
Terebinum, 408 
Ternstromiaceae, 133 
Terpenes, 51 



INDEX. 



711 



Terpin hydrate, 408 
Terpineol, 226 
Terpini hydras, 408 
Terra japonica, 184 
Tetanocannabine, 112 
Tetter wort, 365 
Thalleioquin test, 156 
Thallin, 510 
Thea, 133 

chinensis, 133 
Thebaine, 84 
Theine, 133, 141 
Theobroma, 134 

cacao, 586 
Theobromine, 134, 586 

sodio-salicylate of, 135 
Therapeutics, definition of, 25 

empirical, 25 

rational, 25 
Theriaca, 591 
Thiol, 548 
Thornapple, 105 
Thoroughwort, 151 
Thorp's Spring, 437 
Thrush, parasite, etc., of, 639 
Trematode worms, 644 
Thymelseacese, 383 
Thymene, 233 

Thymol, 233 ; action and uses of, 545 
Tinctura aconiti, 241 

aloes, 357 

et myrrhse, 357 

arnicae florum, 247 
radicis, 247 

asafcetidae, 127 

aurantii amari, 231 
dulcis, 231 

belladonnae foliorum, 104 

benzoini, 420 

composita, 420, 421 

bryonise, 363 

calendula;, 385 

calumbae, 147 

cannabis indicae, 113 

cantharidis, 400 

capsici, 223 

cardamomi 227 

composita, 227 

catechu composita, 184 

chiratae, 148 

cimicifugae, 287 

cinchonae, 161 

composita, 161 

cinnamomi, 224 

colchici seminis, 394 

croci, 599 

cubebse, 413 

digitalis, 281 

ferri chloridi, 433 

gallae, 183 

gelsemii, 317 

gentianae composita, 146 



Tinctura guaiaci, 383 

ammoniata, 383 

humuli, 114 

hydrastis, 268 

hyoscyami, 108 

iodi, 461 

ipecacuanha; et opii, 92, 327 

kino, 185 

krameriae, 186 

lactucarii, 94 

lavandulae composita, 231 

lobeliae, 306 

matico, 415 

moschi, 142 
' myrrhae, 415 

nucis vomica;, 265 

opii, 92 

camphorata, 92 
deodorati, 92 

physostigmatis, 292 

pyrethri, 423 

quassiae, 145 

quillajae, 403 

rhei, 355 

aromatica, 355 
dulcis, 355 
et sennae, 355 

sanguinariae, 329 

saponis viridis, 567 

scillse, 391 

serpentariae, 149 

stramonii seminis, 106 

strophanthi, 283 

sumbul, 322 

tolutana, 422 

valerianse, 132 

ammoniata, 132 

vanillae, 234 

veratri viridis, 244 

zingiberis, 227 
Tincturae herbarum recentium. 60 
Tinctures, 60 

ammoniated, 60 

ethereal, 60 

fresh herbs of, 60 

various official (see tinctura) 
Tobacco, 330; action and uses of, 302 
Tolene, 422 
Tolu, 422 

Toluifera balsamum, 422 
Tonics, 81; action, uses and division of, 
143 

mineral, 143 ; list of, 168 

vegetable, 143 
Topical medicines, 81 ; actions, uses and 

general consideration of, 496 
Tragacanth, 574 
Tragacantha, 574 
Tragacanthin, 574 
Trapp's test for veratrine, 245 
Treacle, 590, 591 
Tremor mercurialis, 440 



712 



INDEX. 



Trichinae spiralis, 646 
Tricresols,51S 
Trimethylamine, 467 
Tri-nitroglycerin, 313 

Triticin, 398 * 

Triticum, 397 

Trituratio elaterini, 372 

Triturationes, 56 

Triturations, 56 

Troches, preparation of 58 ; use of, 76 

acid tannic, 182 

ammonium chloride, 220 

catechu, 184 

chalk, 495 

cubeb, 414 

ginger, 227 

iron, 430 

krameriae, 186 

potassium chlorate, 481 

santonin, 604 

sodium bicarbonate, 489 
Trochisci, 58 

acidi tannici, 182 

ammonii chloridi, 220 

catechu, 184 > 

cretae 495 

cubebse, 414 

ferri, 430 

glycyrrhizae et opii, 91 

ipecacuanhas, 327 

krameriae, 186 

menthae piperitae, 233 

morphinae et ipecacuanha?, 93, 327 

potassii chloratis, 481 

santonini, 604 

sodii bicarbonatis, 489 

zingiberis, 227 
Tropine, 107 
Troy weight, 63 
Tulley's powder, 93 

Turpentine, action and uses of, 404 ; 
Bordeaux, 405 ; Canada, 405 ; 
Chian, 405 ; oil of, 405; action and 
uses of, 406; enemata, 376; rube- 
facient, 553 ; resin, 405 ; as vermi 
cide, 599, 606 

Venice, 405 

white, 405 
Turpeth mineral, as emetic, 331 ; action 

of, 456 
Tussol, 649 
Tutty, 199 

Ulcers, application of medicines to, 73, 80 
Ulmus, 576; fulva,576 
Umbelliferae, 126, 128, 233, 287, 321 
Umbelliferon, 127, 426 
Unguenta, 62 
Unguentum, 584 

acidi carbolici, 51 5 
tannici, 182 

antimonii, 561 



Unguentum, aquae rosae, 189 
belladonna?, 104 
chrysarobini, 568 
diachylon, 196 
gallae, 184 

hydrargyri, 444 ; action and uses of, 
445 

ammoniati, 444 ; action and uses 

of, 456 
nitratis, 444; action and uses of, 

457 
oxidi flavi, 444 ; uses of, 448 
oxidi rubri, 444 ; uses of, 447 
iodi, 462 
iodoformi, 542 
picis liquidae, 408, 410 
plumbi carbonatis, 196 

iodidi, 195 
potassii iodidi, 465 
stramonii, 106 
sulphuris, 339 
veratrinae, 245 
zinci oxidi, 199 
Unna's soaps, 566 
Urginea scilla, 389 
Ursone, 416 

Urticaceae, 111, 113, 333, 576 
Uva ursi, 416 

Valerian, 131 
Valeriana, 131 

officinalis, 131 
Valerianaceae, 131 
Vallet's ferruginous mass, 430 
Vanilla, 234 
Vanilla planifolia, 234 
Vanillin, 234 
Vapor bath, 33 

Vapors, 56 ; method of use, 63 
Vaseline, 589 
Vegetable acids, definition of, 50, 52 

astringents, 180 

cathartic pills, 370 

emetics, 324 
Venesection, 26 
Veratrina, 244 

Veratrine, 241 ; action and uses of, 244 
Veratroidine, 241-2 
Veratrum viride, 241 
Vermicides, 599 
Vermifuges, 599 
Veronica Virginica, 359 
Vesicating taffetas, 560 
Vesicants, 550 ; action and uses of, 555 
Vesication, 34 
Viburnum prunifolium, 318 

opulus, 319 
Vichy waters, 490 
Villosin, 190 
Vina, 61 
Vinegar, 258 

of opium, 92 



INDEX. 



713 



Vinegar, squill, 391 
Vinegars, 61 
Vinum, 215 

album, 215 

antimonii, 252 

colchici radicis, 394 
seminis, 394 

ergotae, 274 

ferri amarum, 436 
citratis, 436 

ipecacuanhae, 327 

opii, 92 

rubrum, 215 
Virginia snakeroot, 148 
Vitellus, 589 
Vitriol blue, 197 

white, 199 
Volatile alkali, 217 

liniment, 554 

oils, 221 
Volt, 40 
Votaic current, 38 

Wahoo, 367 

Warming plaster, 555 

Warner's gout cordial, 355 

Water, 571 ; see aqua for official water.' 

bath, cold, 36 
hot, 33 
tepid, 33 

« vapor, 33 ; warm, 33 

carbonic acid, 572 

cold, 36-7 

distilled, 571 

hot, 33 

ice, action of, 35, 37 and 572 

warm, 33 
Wax, yellow, 585 

white, 585 
Weights and measures, 63 
Weir Mitchell treatment, 48 
Wheat grain, 598 
Whiskey, 216 
White oak, 186 

lead, 196 

pepper, 223 

precipitate, 456 

turpentine, 405 

vitriol, 199 
Whiting, 495 

Wiesbaden Springs, Germany, 351 
Wild cherry, 165 
Wildungen Springs, 496 
Willow, white, 164 
Wine, 215 

antimony, 252 

coca, 135 

colchicum root, 394 
seed, 394 

ergot, 274 

ipecac, 327 

iron, bitter, 436 
citrate, 436 



Wine, Madeira, 215 

measure, 65 

of opium, 92 

port, 215 

red, 215 

sherry, 215 

whey, 215 

white, 215 
Wine glass, 65 
Wines, 61 

alcoholic strength of various, 637 
Wintergreen, 229 
Wistar's cough lozenge, 91 
Witch hazel, 188 
Wolfs bane, 235 
Wool, sublimated, 501 
Woorali, 317 
Woorara, 317, 318 
Woorari, 317 
Wormseed, American, 602 

levant, 603 
Worm-tea, 601 
Worms, round, 646 

thread, 646 

tape, 642-3-5 
Wormwood, 152 

Wounds, application of medicines to, 73, 
80 

Xanthopuccine, 266 
Xanthoxylin, 384 
Xanthoxylum, 384 

Americanum, 384 

clava-herculis, 384 

Yellow bark, 154 
dock, 189 
jasmine, 315 

mercuric oxide, 444 ; action and uses 
of, 447 

subsulphate, 444 ; action and 
uses of, 456 ; as emetic, 331 
mercurous iodide, 444 ; action and 

uses of, 454 
parilla, 385 
wash, 448 
Yolk of egg, 589 

Zea, 399 

mays, 399 ; furnishing starch, 582 
Zinc acetate, 200 

bromide, 301 

carbonate, precipitated, 200 

chloride, action and uses of, 200 ; as 
escharotic, 565 

iodide, 201 

oxide, 199 

phosphide, 179 

preparations, 198 

sulphate, action and uses of, 199; as 
emetic, 331 

sulpho carbolate, 516 

valerianate, 201 



714 



INDEX. 



Zinci acetas, 200 

bromidum, 301 

carbonas pr<ecipitatus, 200 

chloridum, action and uses of, 200 

as escharotic, 565 
iodidum, 201 
oxidum, 199 

venale, 199 
praeparata, 198 



Zinci phosphidum, 179 

sulphas, action and uses of, 199; as 

emetic, 331 
valerianas, 201 
Zingiber, action and uses of, 226; as rube- 
facient, 555 
officinalis, 226 
Zygophylleae, 382 



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HARE. Mediastinal Disease. The Pathology, Clinical History and Diagnosis of 
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MEDICAL AND SCIENTIFIC PUBLICA TIONS. 15 

HOVEL L. Diseases of the Ear and Naso-Pharynx. A Treatise including 
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KLEEN AND HARTWELL. Handbook of Massage. By Emil Kleen, m.d., 
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"The most complete resume of all the facts in physiology in the language." — The Lancet. 
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16 P. BLAKISTON, SON &» CO.'S 



LEFFM ANN'S Compend of Medical Chemistry, Inorganic and Organic. In- 
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No. I. HUMAN ANATOMY. Fifth Revised and Enlarged Edition. Including Visceral Anatomy. Can 
be used with either Morris's or Gray's Anatomy. 117 Illustrations and 16 Lithographic Plates of Nerves and 
Arteries, with Explanatory Tables, etc. By Samuel O. L Potter, m.d., Professor of the Practice of 
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No. 2. PRACTICE OF MEDICINE. Parti. Fifth Edition, Revised, Enlarged, and Improved. By 
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No. 4. PHYSIOLOGY. Seventh Edition, with new Illustrations and a table of Physiological Constants. 
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No. 5. OBSTETRICS. Fifth Edition. By Humpy G. Landis, m.d. Revised and Edited by Wm. H. 
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47 Illustrations. 

No. 6. MATERIA MEDICA, THERAPEUTICS, AND PRESCRIPTION WRITING. Sixth 
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No. 7. GYNAECOLOGY. A New Book. By Wm. H. Wells, m.d.. Assistant Demonstrator of Obstetrics, 
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No. 8. DISEASES OF THE EYE AND REFRACTION. Second Edition. Including Treatment and 
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No. g. SURGERY, Minor Surgery, and Bandaging. Fifth Edition, Enlarged, and Improved. Hy 
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No. 10. MEDICAL CHEMISTRY. Fourth Edition. Including Urinalysis, Animal Chemistry Chemistry 
ot Milk, Blood, Tissues, the Secretions, etc By Henky Leffmann, m.d,, Professor of Chemistry in 
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No. II. PHARMACY. Fifth Edition. Based upon Prof. Remington's Text-Book of Pharmacy. By F. 
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Lecturer at Jefferson Medical College. Carefully revised in accordance with the new U. S. P. 

No. 12. VETERINARY ANATOMY AND PHYSIOLOGY. Illustrated. By Wm. R. Bai.lou. m.d., 
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No. 13. DENTAL PATHOLOGY AND DENTAL MEDICINE. Second Edition, Illustrated. Con- 
taining all the most noteworthy points of interest to the Dental Student and a Section on Emergencies. By 
Geo. \V. Warren, d.d s., Chief of Clinical Staff, Pennsylvania College of Dental Surgery, Philadelphia. 

No. 14. DISEASES OF CHILDREN. Colored Plate. By Marcus P. Hatfield, Professor of Dis- 
eases of Children, Chicago Medical College. 

No. 15. GENERAL PATHOLOGY AND MORBID ANATOMY. 91 Illustrations. By IT. New- 
berry Hall, ph.g., m.d., Professor of Pathology and Medical Chemistry, Chicago Post-Graduate Medical 
School. 

Price, each, $1.00. Interleaved, for taking- Notes, $1.25. 

P. BLAKISTON, SON & CO., Publishers, 

1012 Walnut Street, Philadelphia. 



Published Annually for 44 Years. 



The Physicians Visiting List. 

(LINDSAY & BLAKISTON'S. ) 
Contents. — Special Revised Edition for 1S95. 



CALENDAR, 1895-1896. 

TABLE OF SIGNS, to be used in keeping records. 

THE METRIC OR FRENCH DECIMAL SYSTEM OF 
WEIGHTS AND MEASURES. 

TABLE FOR CONVERTING APOTHECARIES' 
WEIGHTS AND MEASURES INTO GRAMS. 

POSOLOGICAL TABLE (Meadows). 

DOSE TABLE, giving the doses of official and unofficial drugs 
in both the English and Metric Systems. Completely re- 
written and rearranged for 1894 by Dr. George M. Gould. 

LIST OF NEW REMEDIES, 1894. 

INCOMPATIBILITY (Dr. S. O. L. Potter). 



POISONS AND ANTIDOTES. 

DISINFECTANTS. 

EXAMINATION OF URINE {Based upon Tyson, Eight* 

Edition). 
BRIGHT'S DIS EASE, Differential Diagnosis of. 
DIAGNOSIS AND TREATMENT OF THE SIMPLEI 

DISEASES OF THE EYE (Dr. George M. Gould). 
THE ERUPTIVE FEVERS, Table of. 
ASPHYXIA AND APNCEA. 
COMPLETE TABLE FOR CALCULATING TBU 

PERIOD OF UTERO-GESTATION. 
COMPARISON OF THERMOMETERS. 



AND THE USUAL BLANK LEAVES FOR KEEPING ACCOUNTS, RECORDS, ENGAGEMENTS. ETC. 



SIZES AND PRICES. 



REGULAR EDITION. 



For 25 


Patients weekly. Tucks, Pockets and Pencil, 


5° 


<< ft <> 


75 


" " " 


100 


" " " 


50 


•■ ■vh.itestei - 


*oo 


■■ ■▼<*. teste:}- 




INTERLEAVED EDITION. 


For 25 


Patients weekly. Interleaved, Tucks and Pencil, 


50 


** " 


50 


«« ~ wi,. (Jan. to June 1 „ „ 
2 VoIs - 1 i,w to rw f 



$1.00 

1.25 

1.50 

2.00 
2.50 
3-oo 



1.25 
1.50 

3.00 



|I.2< 



PERPETUAL EDITION, without Dates, 

No. 1. Containing space for over 1300 names, with blank 
page opposite each Visiting List page. Bound 
in Red Leather cover, with Pocket and 
Pencil, .... 

No. 2. Containing space for 2600 names, with blank 
page opposite each Visiting List page. Bound 
like No. 1, with Pocket and Pencil, 
MONTHLY EDITION, without Dates. 

No. 1. Bound, Seal leather, without Flap or Pencil, 
gilt edges, ..... 

No. 2. Bound, Seal leather, with Tucks, Pencil, etc., 
gilt edges. .... 



SPECIAL. SIZES AND BINDINGS MADE TO ORDER. 



" The fact that this Visiting List has been published annually for forty years is suffi- 
cient guarantee of its excellence and popularity. In addition to the visiting list proper, 
it contains easily-accessible suggestions upon many of the emergencies that may arise in 
a physician's practice, as when he is too far from home to learn from his text-books the 
antidote for a poison that may have been swallowed, or the proper method of resuscitating 
a half-drowned person. True, he should know these things, but who does not occasion- 
ally forget, when he most wishes to remember ? There are also dose-tables, tables of the 
metric system, a list of new remedies, rules for examining urine, a table for calculating 
the period of pregnancy, and other equally useful information. The arrangement for 
entering patients, visits, consultations, etc., is exceeding simple, and the whole makes a 
thin, compact, and easily-carried volume." — Medical News, Philada. 

B^The Perpetual and Monthly Editions carubey^ommenced at any time and 
used until full. |t ]) ,2, Y oM . 

jggg^This is a plain, systematic method of keeping a record of visits ; well printed, 
strongly bound, durable, convenient, and small. 

This Visiting List is published in November of each year. 

P. BLAKISTON, SON & CO., PHILADELPHIA. 



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